Strength training in prepubertal children is one of the topics that has aroused the most interest and controversy among training professionals in recent years. Therefore, the aim of the present study was to analyze the available scientific evidence on the influence of strength training variables on morphological and/or neuromuscular adaptations in healthy prepubertal populations with no previous experience in this type of training according to the descriptive sample characteristics. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, 22 studies were selected after a systematic search and selection process using four electronic databases: Google Scholar, PubMed, Scopus, and SPORT Discus. Furthermore, the internal validity of the studies included was assessed using the modified PEDro scale. The sample consisted of 604 prepubertal children (age, 10.02 ± 0.75 years), of whom 473 were boys and 131 were girls, with 104 strength training programs recorded. Strength training resulted in a significant increase in jumping (n = 29) and sprinting (n = 13) abilities. Moreover, muscle strength was increased in 100% of the cases. Morphologically, strength training resulted in a decrease in body fat percentage (n = 19) and an increase in lean body mass (n = 17). With regard to gender, increases in general sport skills and basic physical abilities were significant in males but not in females. Thus, the results are more heterogeneous in girls due to the small number of studies carried out. Therefore, this research provides practical applications for coaches to design and implement more effective training programs to maximize adaptations, enhance physical performance, and reduce injury risk.
An understanding of physical demands during official competitions is essential to achieving the highest performance in handball. The aim of this systematic review was to summarise the available scientific evidence associated with physical demands during official competitions in elite handball according to playing positions, competition level and gender. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 17 studies were selected after a systematic search and selection process of three digital databases: PubMed, Web of Science and Sport Discus. The quality of the selected studies was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology checklist; the average score was 18.47 points. The sample consisted of 1175 handball players, of whom 1042 were men (88.68%) and 133 were women (11.32%). The results show that an elite handball player covered on average 3664.4 ± 1121.6 m during a match. The average running pace was 84.8 ± 17.2 m∙min−1. The total distance covered was largely greater in national competitions (4506.7 ± 647.9 m) compared with international competitions (2190.3 ± 1950.5 m) (effect size (ES) = 1.2); however, the running pace did not present any significant difference between the international or national level (ES = 0.06). In regard to gender, the total distance covered was moderately greater in female competitions (4549.1 ± 758.6 m) compared with male competitions (3332.6 ± 1257.7 m) (ES = 0.9), and the running pace was largely greater in female competitions (110.5 ± 7.2 m∙min−1) compared with male competitions (78.4 ± 19.7 m∙min−1) (ES = 1.6). In relation to playing position, backs and wings covered a moderately greater total distance (ES = 0.7 and 0.6) and slightly more meters per minute (ES = 0.4 and 0.2) than pivots. Moreover, the technical activity profile differed between playing positions. Backs performed moderately more throws than pivots and wings (ES = 1.2 and 0.9), pivots exhibited largely more body contact than backs and wings, and wings performed moderately more fast breaks (6.7 ± 3.0) than backs (2.2 ± 2.3) (ES = 1.8). Therefore, this research study provides practical applications for handball coaches and strength and conditioning professionals with respect to designing and implementing more individualised training programmes to maximise performance and reduce injury risk.
Injuries are common in team sports and can impact both team and individual performance. In particular, hamstring strain injuries are some of the most common injuries. Furthermore, hamstring injury ratios, in number of injuries and total absence days, have doubled in the last 21 seasons in professional soccer. Weakness in hip extensor strength has been identified as a risk factor in elite-level sprinters. In addition, strength imbalances of the hamstring muscle group seem to be a common cause of hamstring strain injuries. In this regard, velocity-based training has been proposed to analyze deficits in the force–velocity profile. Previous studies have shown differences between men and women, since there are biomechanical and neuromuscular differences in the lower limbs between sexes. Therefore, the aim of this study was to compare the load–velocity profile between males and females during two of the most important hip extension exercises: the hip thrust and the deadlift. Sixteen men and sixteen women were measured in an incremental loading test following standard procedures for the hip thrust and deadlift exercises. Pearson’s correlation (r) was used to measure the strength of the correlation between movement velocity and load (%1RM). The differences in the load–velocity relationship between the men and the women were assessed using a 2 (sex) × 15 (load) repeated-measures ANOVA. The main findings revealed that: (I) the load–velocity relationship was always strong and linear in both exercises (R2 range: 0.88–0.94), (II) men showed higher velocities for light loads (30–50%1RM; effect size: 0.9–0.96) than women for the deadlift, but no significant differences were found for the hip thrust. Based on the results of this study, the load–velocity equations seem to be sex-specific. Therefore, we suggest that using sex-specific equations to analyze deficits in the force–velocity profile would be more effective to control intensity in the deadlift exercise.
Introduction Surgically managed appendicitis exhibits great heterogeneity in techniques for mesoappendix transection and appendix amputation from its base. It is unclear whether a particular surgical technique provides outcome benefit or reduces complications. Material and methods We undertook a pre-specified subgroup analysis of all patients who underwent laparoscopic appendectomy at index admission during SnapAppy (ClinicalTrials.gov Registration: NCT04365491). We collected routine, anonymized observational data regarding surgical technique, patient demographics and indices of disease severity, without change to clinical care pathway or usual surgeon preference. Outcome measures of interest were the incidence of complications, unplanned reoperation, readmission, admission to the ICU, death, hospital length of stay, and procedure duration. We used Poisson regression models with robust standard errors to calculate incident rate ratios (IRRs) and 95% confidence intervals (CIs). Results Three-thousand seven hundred sixty-eight consecutive adult patients, included from 71 centers in 14 countries, were followed up from date of admission for 90 days. The mesoappendix was divided hemostatically using electrocautery in 1564(69.4%) and an energy device in 688(30.5%). The appendix was amputated by division of its base between looped ligatures in 1379(37.0%), with a stapler in 1421(38.1%) and between clips in 929(24.9%). The technique for securely dividing the appendix at its base in acutely inflamed (AAST Grade 1) appendicitis was equally divided between division between looped ligatures, clips and stapled transection. However, the technique used differed in complicated appendicitis (AAST Grade 2 +) compared with uncomplicated (Grade 1), with a shift toward transection of the appendix base by stapler (58% vs. 38%; p < 0.001). While no statistical difference in outcomes could be detected between different techniques for division of appendix base, decreased risk of any [adjusted IRR (95% CI): 0.58 (0.41–0.82), p = 0.002] and severe [adjusted IRR (95% CI): 0.33 (0.11–0.96), p = 0.045] complications could be detected when using energy devices. Conclusions Safe mesoappendix transection and appendix resection are accomplished using heterogeneous techniques. Technique selection for both mesoappendix transection and appendix resection correlates with AAST grade. Higher grade led to more ultrasonic tissue transection and stapled appendix resection. Higher AAST appendicitis grade also correlated with infection-related complication occurrence. Despite the overall well-tolerated heterogeneity of approaches to acute appendicitis, increasing disease acuity or complexity appears to encourage homogeneity of intraoperative surgical technique toward advanced adjuncts.
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