The Response of the Amputee Athlete Heart to Chronic Core Exercise: A Study on Hematological and Biochemical Parameters, and N-Terminal Pro Brain Natriuretic Peptide.

Background and Objectives: mortality and morbidity due to cardiovascular causes are frequently experienced in amputees. Research on the effects of chronic exercise on biomarkers and cardiac damage indicators in these individuals is limited. The aim of this study was to investigate the effects of a core training program on brain natriuretic-related peptide, as well as hematological and biochemical parameters in amputee soccer players. Materials and Methods: The participants were randomly allocated to the following two groups: a core exercise group (CEG) and a control group (CG). While the CG continued routine soccer training, the CEG group was included in a core exercise program different from this group. During the study, routine hemogram parameters of the participants, various biochemical markers, and the concentration of brain natriuretic-related peptide (NT-pro-BNP) were analyzed. Results: after the training period, notable improvements in various hematological parameters were observed in both groups. In the CEG, there were significant enhancements in red blood cell count (RBC), hematocrit (HCT), mean corpuscular hemoglobin concentration (MCHC), and mean corpuscular hemoglobin (MCH) values. Similarly, the CG also showed substantial improvements in RBC, HCT, mean corpuscular volume (MCV), MCHC, MCH, red cell distribution width-standard deviation (RDW-SD), platelet-to-lymphocyte ratio (PLCR), mean platelet volume (MPV), and platelet distribution width (PDW). Moreover, in the CEG, serum triglycerides (TG) and maximal oxygen uptake (MaxVO2) exhibited significant increases. Conversely, TG levels decreased in the CG, while high-density lipoprotein (HDL), low-density lipoprotein (LDL), and MaxVO2 levels demonstrated substantial elevations. Notably, the N-terminal pro-brain natriuretic peptide (BNP) levels did not undergo significant changes in either the CEG or the CG following the core exercise program (p > 0.05). However, in the CEG, a meaningful positive correlation was observed between NT-pro-BNP and creatine kinase (CK) levels before and after the core exercise program. Conclusions: the findings emphasized the potential benefits of core training in enhancing specific physiological aspects, such as erythrocyte-related parameters and lipid metabolism, as well as aerobic capacity. Furthermore, the observed correlation between NT-pro-BNP and CK levels in the CEG provides intriguing insights into the unique physiological adaptations of amputee athletes.

Sporting activity does not fully prevent bone demineralization at the impaired hip in athletes with amputation.

There is lack of information about bone mineralization at the lumbar spine and bilateral hips of athletes with unilateral lower limb amputation. The present study assessed for the first time the areal bone mineral density at the lumbar spine and at the hip of the able and impaired leg by means of Dual-Energy X-Ray Absorptiometry using a large sample (N = 40) of male athletes. Results showed that bone demineralization in athletes with unilateral lower limb amputation is found at the impaired hip but not at the lumbar spine and may therefore be site-specific. The extent of hip demineralization was influenced by the level of amputation, with about 80% of athletes with above knee amputation and 10% of athletes with below knee amputation showing areal bone mineral density below the expected range for age. Nevertheless, a reduced percentage of fat mass and a lower fat-to-lean mass ratio in the residual impaired leg as well as a greater amount of weekly training was positively associated with bone mineralization at the impaired hip (partial correlation coefficients = 0.377-0.525, p = 0.040-0.003). Results showed that participation in adapted sport has a positive effect on bone health in athletes with unilateral lower limb amputation but is not sufficient to maintain adequate levels of bone mineralization at the impaired hip in athletes with above-knee amputation. Accordingly, physical conditioners should consider implementing sporting programs, according to the severity of the impairment, aimed at improving bone mineralization at the impaired hip and improve body composition in the residual impaired leg.

Sports Performance Tests for Amputee Football Players: A Scoping Review.

BACKGROUND: This scoping review aims to identify sports performance tests for amputee football players and to critically analyze the methodological quality, validation data, reliability, and standardization of sport-specific tests to indicate the best-fitting tests. METHODS: Electronic database searches were conducted between January 2019 and October 2021. Twelve articles met the inclusion criteria. Qualitative assessment of each study was conducted by STROBE checklist. RESULTS: Twenty-nine sports performance tests were identified. No sports performance test fully met all three criteria associated with the qualitative assessment of tests. The critical appraisal of the articles demonstrates a gap in study design, settings, and main results description. Some inconsistencies were found in the methodological descriptions of tests assessing the same motor skill. A STROBE score of 13 points was considered a satisfactory score for the article (it was obtained by 8 of the 12 studies). The weakest point of the analyzed studies was the description of how the test group size was accessed and later obtained. CONCLUSIONS: No test was found that was simultaneously presented as valid, reliable, and standardized. The authors can recommend the use of the two-sports performance tests that are the closest to ideal: the L test and the YYIRT1.

Assessment of the upper limbs maximum power and the locomotion speed in amputee football players

Abstract Aim: The purpose of the study was to assess upper limbs' maximum power and locomotion speed among amputee football (amputee soccer) players. Methods: The 30-s Wingate Anaerobic test and the 20-m sprint test were performed. Anthropometric measurements and body composition (Body mass index (BMI), percentage of body fat (% BF), and lean body mass (LBM)) were examined. Results: BMI significantly differentiated forwards and defenders (p < 0.05). Peak power (PP) and mean power (MP) were related to LBM (p < 0.05), thus defenders reached higher values of PP, in comparison to forwards. % BF and BMI were related to relative mean power (rMP) (p < 0.05). Field position differentiated players in terms of upper limbs' relative peak power (rPP) in favour of forwards (p < 0.05). Age was a significant factor for speed velocity on 10 m and 20 m (p < 0.05). There was no relationship between upper limbs' power and locomotion speed. Conclusion: Body composition, especially % BF may influence on the anaerobic performance of amputee football players.

Postural Control during Progressively Increased Balance-Task Difficulty in Athletes with Unilateral Transfemoral Amputation: Effect of Ocular Mobility and Visuomotor Processing.

This study examined postural control during single leg stance test with progressively increased balance-task difficulty in soccer players with unilateral transfemoral amputation (n = 11) compared to able-bodied soccer players (n = 11). The overall stability index (OSI), the anterior/posterior stability index, and the medial/lateral stability index during three balance tasks with increasing surface instability were estimated. The oculomotor and visuomotor contribution to postural control in disabled athletes was analyzed. Oculomotor function, simple and choice reaction times, and peripheral perception were assessed in a series of visuomotor tests. The variation in OSI demonstrated significantly greater increases during postural tests with increased balance-task difficulty in the able-bodied soccer players compared to amputees (F(2,40) = 3.336, p < 0.05). Ocular mobility index correlated (p < 0.05) with OSI in conditions of increasing balance-task difficulty. Moreover, speed of eye-foot reaction has positive influence (p < 0.05) on stability indexes in tasks with an unstable surface. Amputee soccer players displayed comparable postural stability to able-bodied soccer players. Disabled athletes had better adaptability in restoring a state of balance in conditions of increased balance-task difficulty than the controls. The speed of visuomotor processing, characterized mainly by speed of eye-foot reaction, significantly contributed to these results.

Soccer practice and functional and social performance of men with lower limb amputations.

Practicing sports together with rehabilitative treatment improves the development of motor, social and emotional abilities of lower limb amputees. The aim of this study was to compare the functional and social performance of individuals with lower limb amputations between those who played soccer and those who did not engage in any sports activities. A total of 138 individuals participated in the study and were divided into two groups: soccer players (n = 69, 34 ± 8.1 years) and non-athletes (n = 69, 38 ± 8.9 years). A checklist, based on the International Classification of Functioning, Disability and Health, was used. Data were analyzed using the Chi-square and Mann-Whitney tests. The soccer players group showed significantly better performance than the non-athletes group in most items of body function, body structure, occupational performance components and daily activities (p < 0.001 for all), and also in some important items of social and environment factors (p < 0.001 for all). The results strongly suggest that amputee soccer significantly improves the functional and social performance in individuals with lower limb amputations.