Aim: Previous research into the etiology of neuromuscular fatigue following competitive soccer match-play has primarily focused on peripheral perturbations, with limited research assessing central nervous system function in the days post-match. The aim of the present study was to examine the contribution and time-course of recovery of central and peripheral factors toward neuromuscular fatigue following competitive soccer match-play.Methods: Sixteen male semi-professional soccer players completed a 90-min soccer match. Pre-, post- and at 24, 48, and 72 h participants completed a battery of neuromuscular, physical, and perceptual tests. Maximal voluntary contraction force (MVC) and twitch responses to electrical (femoral nerve) and transcranial magnetic stimulation (TMS) of the motor cortex during isometric knee-extension and at rest were measured to assess central nervous system (voluntary activation, VA) and muscle contractile (potentiated twitch force, Qtw, pot) function. Electromyography responses of the rectus femoris to single- and paired-pulse TMS were used to assess corticospinal excitability and short-interval intracortical inhibition (SICI), respectively. Fatigue and perceptions of muscle soreness were assessed via visual analog scales, and physical function was assessed through measures of jump (countermovement jump height and reactive strength index) and sprint performance.Results: Competitive match-play elicited significant post-match declines in MVC force (−14%, P < 0.001) that persisted for 48 h (−4%, P = 0.01), before recovering by 72 h post-exercise. VA (motor point stimulation) was reduced immediately post-match (−8%, P < 0.001), and remained depressed at 24 h (−5%, P = 0.01) before recovering by 48 h post-exercise. Qtw,pot was reduced post-match (−14%, P < 0.001), remained depressed at 24 h (−6%, P = 0.01), before recovering by 48 h post-exercise. No changes were evident in corticospinal excitability or SICI. Jump performance took 48 h to recover, while perceptions of fatigue persisted at 72 h.Conclusion: Competitive soccer match-play elicits substantial impairments in central nervous system and muscle function, requiring up to 48 h to resolve. The results of the study could have important implications for fixture scheduling, the optimal management of the training process, squad rotation during congested competitive schedules, and the implementation of appropriate recovery interventions.

A pediatric trauma MTP is feasible and allows for rapid provision of balanced blood products for transfusion to coagulopathic children. Larger studies are warranted to determine whether such protocols will improve outcomes for pediatric trauma patients.

ET, −18%, P ≤ 0.01), and voluntary activation measured with TMS (−11, −15 and −17%, respectively, P ≤ 0.01) were evident. The fatigue response was robust across both trials; the change in MVC at each time point demonstrated a good level of reliability (CV range 6-11%; ICC 2,1 0.83-0.94), whilst the responses identified with motor nerve stimulation showed a moderate level of reliability (CV range 5-18%; ICC 2,1 0.63-0.89) and the data obtained with motor cortex stimulation showed an excellent level of reliability (CV range 3-6%; ICC 2,1 0.90-0.98). Conclusion Simulated soccer exercise induces a significant level of fatigue, which is consistent on repeat tests, and involves both central and peripheral mechanisms. Keywords

Harper, LD, Hunter, R, Parker, P, Goodall, S, Thomas, K, Howatson, G, West, DJ, Stevenson, E, and Russell, M. Test-retest reliability of physiological and performance responses to 120 minutes of simulated soccer match play. J Strength Cond Res 30(11): 3178-3186, 2016-This study investigated the test-retest reliability of physiological and performance responses to 120 minutes (90 minutes plus 30 minutes extra-time [ET]) of the soccer match simulation (SMS). Ten university-standard soccer players completed the SMS on 2 occasions under standardized conditions. Capillary and venous blood was taken pre-exercise, at half-time, and at 90 and 120 minutes, with further capillary samples taken every 15 minutes throughout the exercise. Core temperature (Tcore), physical (20- and 15-m sprint speeds and countermovement jump height), and technical (soccer dribbling) performance was also assessed during each trial. All variables except blood lactate demonstrated no systematic bias between trials (p > 0.05). During the last 15 minutes of ET, test-rest reliability (coefficient of variation %, Pearson's r, respectively) was moderate to strong for 20-m sprint speed (3.5%, 0.71), countermovement jump height (4.9%, 0.90), dribble speed (2.8%, 0.90), and blood glucose (7.1%, 0.93), and very strong for Tcore (1.2%, 0.99). Moderate reliability was demonstrated for 15-m sprint speed (4.6%, 0.36), dribble precision (11.5%, 0.30), plasma insulin (10.3%, 0.96), creatine kinase ([CK] 28.1%, 0.38), interleukin-6 (24%, 0.99), nonesterified fatty acids ([NEFA] 13.2%, 0.73), glycerol (12.5%, 0.86), and blood lactate (18.6%, 0.79). In the last 15 minutes of ET, concentrations of blood glucose and lactate and sprint and jump performances were reduced, whereas Tcore, NEFA, glycerol, and CK concentrations were elevated (p ≤ 0.05). The SMS is a reliable protocol for measuring responses across the full 120 minutes of soccer-specific exercise. Deleterious effects on performance and physiological responses occur during ET.

Strength, jump, and sprint training requiring repeated maximum efforts elicits fatigue that requires up to 72 h to fully resolve, but this fatigue is not primarily underpinned by decrements in CNS function.

Compartment syndrome is characterised by an increase in the interstitial pressure within a closed osseofascial compartment. This may be due to a decrease in compartment volume, an increase in compartment content or external pressures. We report 4 patients who required surgical decompression for gluteal compartment syndrome that developed after joint arthroplasty. Gluteal compartment syndrome is rare, has high morbidity, and can be life threatening if not detected early. We emphasise the importance of identifying patients at risk, frequent monitoring of patients with continuous epidural infusions, reporting of motor blockade, and regular changing of the patient's position postoperatively.

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