Movement demands and perceived wellness associated with preseason training camp in NCAA Division I college football players

The aims of this study were to examine the movement demands of preseason practice in National Collegiate Athletic Association Division I college football players using portable global positioning system (GPS) technology and to assess perceived wellness associated with preseason practice to determine whether GPS-derived variables from the preceding day influence perceived wellness the following day. Twenty-nine players were monitored using GPS receivers (Catapult Innovations, Melbourne, Australia) during 20 preseason practices. Individual observations (n = 550) were divided into offensive and defensive position groups. Movement variables including low-, medium-, high-intensity, and sprint distance, player load, and acceleration and deceleration distance were assessed. Perceived wellness ratings (n = 469) were examined using a questionnaire which assessed fatigue, soreness, sleep quality, sleep quantity, stress, and mood. A 1-way analysis of variance for positional movement demands and multilevel regressions for wellness measures were used, followed by post hoc testing to evaluate the relational significance between categorical outcomes of perceived wellness scores and movement variables. Results demonstrated significantly (p ≤ 0.05) greater total, high-intensity, and sprint distance, along with greater acceleration and deceleration distances for the defensive back and wide receiver position groups compared with their respective offensive and defensive counterparts. Significant (p ≤ 0.05) differences in movement variables were demonstrated for individuals who responded more or less favorably on each of the 6 factors of perceived wellness. Data from this study provide novel quantification of the position-specific physical demands and perceived wellness associated with college football preseason practice. Results support the use of position-specific training and individual monitoring of college football players

Impact of Evidence‐Based Stroke Care on Patient Outcomes: A Multilevel Analysis of an International Study

Background The uptake of proven stroke treatments varies widely. We aimed to determine the association of evidence‐based processes of care for acute ischemic stroke ( AIS ) and clinical outcome of patients who participated in the HEADPOST (Head Positioning in Acute Stroke Trial), a multicenter cluster crossover trial of lying flat versus sitting up, head positioning in acute stroke. Methods and Results Use of 8 AIS processes of care were considered: reperfusion therapy in eligible patients; acute stroke unit care; antihypertensive, antiplatelet, statin, and anticoagulation for atrial fibrillation; dysphagia assessment; and physiotherapist review. Hierarchical, mixed, logistic regression models were performed to determine associations with good outcome (modified Rankin Scale scores 0–2) at 90 days, adjusted for patient and hospital variables. Among 9485 patients with AIS, implementation of all processes of care in eligible patients, or “defect‐free” care, was associated with improved outcome (odds ratio, 1.40; 95% CI, 1.18–1.65) and better survival (odds ratio, 2.23; 95% CI , 1.62–3.09). Defect‐free stroke care was also significantly associated with excellent outcome (modified Rankin Scale score 0–1) (odds ratio, 1.22; 95% CI , 1.04–1.43). No hospital characteristic was independently predictive of outcome. Only 1445 (15%) of eligible patients with AIS received all processes of care, with significant regional variations in overall and individual rates. Conclusions Use of evidence‐based care is associated with improved clinical outcome in AIS . Strategies are required to address regional variation in the use of proven AIS treatments. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique Identifier: NCT 02162017. </jats:sec

Impact of Evidence-Based Stroke Care on Patient Outcomes: A Multilevel Analysis of an International Study

Background-The uptake of proven stroke treatments varies widely. We aimed to determine the association of evidence-based processes of care for acute ischemic stroke (AIS) and clinical outcome of patients who participated in the HEADPOST (Head Positioning in Acute Stroke Trial), a multicenter cluster crossover trial of lying flat versus sitting up, head positioning in acute stroke. Methods and Results-Use of 8 AIS processes of care were considered: reperfusion therapy in eligible patients; acute stroke unit care; antihypertensive, antiplatelet, statin, and anticoagulation for atrial fibrillation; dysphagia assessment; and physiotherapist review. Hierarchical, mixed, logistic regression models were performed to determine associations with good outcome (modified Rankin Scale scores 0-2) at 90 days, adjusted for patient and hospital variables. Among 9485 patients with AIS, implementation of all processes of care in eligible patients, or defect-free care, was associated with improved outcome (odds ratio, 1.40; 95% CI, 1.18-1.65) and better survival (odds ratio, 2.23; 95% CI, 1.62-3.09). Defect-free stroke care was also significantly associated with excellent outcome (modified Rankin Scale score 0-1) (odds ratio, 1.22; 95% CI, 1.04-1.43). No hospital characteristic was independently predictive of outcome. Only 1445 (15%) of eligible patients with AIS received all processes of care, with significant regional variations in overall and individual rates. Conclusions-Use of evidence-based care is associated with improved clinical outcome in AIS. Strategies are required to address regional variation in the use of proven AIS treatments.National Health and Medical Research Council of AustraliaUniv New South Wales, Fac Med, George Inst Global Hlth, Sydney, NSW, AustraliaCtr Estudios Clin, Inst Ciencias & Innovac Med, Santiago, ChileClin Alemana Univ Desarrollo, Fac Med, Serv Neurol, Dept Neurol & Psiquiatria, Santiago, ChilePeking Univ, Hlth Sci Ctr, George Inst Global Hlth, Beijing, Peoples R ChinaAustralian Catholic Univ, Nursing Res Inst, St Vincents Hlth Australia Sydney, Sydney, NSW, AustraliaUniv Cent Lancashire, Fac Hlth & Wellbeing, Preston, Lancs, EnglandUniv Chile, Fac Med, Dept Ciencias Neurol, Santiago, ChileUniv Sao Paulo, Ribeirao Preto Med Sch, Stroke Serv Neurol Div, Ribeirao Preto, BrazilFukuoka Univ, Fac Med, Dept Prevent Med & Publ Hlth, Fukuoka, Fukuoka, JapanUniv Leicester, Dept Cardiovasc Sci, Leicester Biomed Res Ctr, Leicester, Leics, EnglandUniv Leicester, Natl Inst Hlth Res, Leicester Biomed Res Ctr, Leicester, Leics, EnglandUniv Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, ScotlandGeorge Inst Global Hlth, Sydney, NSW, AustraliaUniv Desarrollo, Serv Neurol, Dept Neurol & Psiquiatria Clin Alemana Santiago, Santiago, ChileSt Vincents Hlth Australia Sydney, Sydney, NSW, AustraliaAustralian Catholic Univ, Sydney, NSW, AustraliaUniv Cent Lancashire, Stroke Practice Res Unit, Sch Hlth, Lancashire Clin Trials Unit, Preston, Lancs, EnglandUniv Leicester, Dept Cardiovasc Sci, Cardiovasc Res Ctr, British Heart Fdn, Leicester, Leics, EnglandUniv Kelaniya, Dept Pharmacol, Fac Med, Colombo, Sri LankaChristian Med Coll & Hosp, Dept Neurol, Ludhiana, IndiaKaohsiung Med Univ & Hosp, Dept Neurol, Kaohsiung, TaiwanLinkou Chang Gung Mem Hosp, Dept Neurol, Taipei, TaiwanPeking Union Med Coll Hosp, Beijing, Peoples R ChinaUniv Sao Paulo, Ribeirao Preto Sch Med, Ribeirao Preto, BrazilMonash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic, AustraliaUniv Cent Lancashire, Sch Hlth Sci, Coll Hlth & Wellbeing, Preston, Lancs, EnglandUniv Desarrollo, Santiago, ChileUniv New South Wales, Neurosci Res Australia, Sydney, NSW, AustraliaNatl Univ Singapore, Dept Pharmacol, Singapore, SingaporeBradford Royal Infirm, Bradford Inst Hlth Res, Leeds, W Yorkshire, EnglandChristian Med College, Ludhiana, Punjab, IndiaRemediumOne Pvt Ltd, Kandy, Sri LankaKaohsiung Med Univ, Chung Ho Mem Hosp, Kaohsiung, TaiwanCalvary Publ Hosp Bruce, Bruce, AustraliaRoyal North Shore Hosp, St Leonards, NSW, AustraliaRoyal Prince Alfred Hosp, Camperdown, NSW, AustraliaConcord Repatriat Gen Hosp, Camperdown, NSW, AustraliaFiona Stanley Hosp, Camperdown, NSW, AustraliaMacquarie Base Hosp, Melbourne, Vic, AustraliaUniv Sao Paulo, Fac Med Ribeirao Preto, Hosp Clin, Sao Paulo, BrazilHosp Governador Celso Ramos, Florianopolis, SC, BrazilSao Paulo State Univ, Hosp Fac Med Botucatu, UNESP, Sao Paulo, BrazilYangquan Coalmine Grp Gen Hosp, Yangquan, Peoples R ChinaNanjing Med Univ, Nanjing Hosp 1, Nanjing, Jiangsu, Peoples R China85 Hosp Peoples Liberat Army, Beijing, Peoples R ChinaChifeng Univ, Affiliated Hosp, Chifeng, Peoples R ChinaBeijing Pinggu Hosp, Beijing, Peoples R ChinaWenzhou Med Univ, Affiliated Hosp 1, Wenzhou, Peoples R ChinaSoochow Univ, Affiliated Hosp 2, Suzhou, Peoples R ChinaHebei Med Univ, Hosp 3, Shijiazhuang, Hebei, Peoples R ChinaCapital Med Univ, Xuanwu Hosp, Beijing, Peoples R ChinaJining Med Univ, Affiliated Hosp, Jining, Peoples R ChinaThird Peoples Hosp Huizhou, Huizhou, Peoples R ChinaSecond Cangzhou Cent Hosp, Cangzhou, Peoples R ChinaShanghai Jiao Tong Univ, Hosp Affiliated, Sch Med, Shanghai, Peoples R ChinaBaogang Hosp, Baotou, Peoples R ChinaHarbin Med Univ, Affiliated Hosp 1, Harbin, Heilongjiang, Peoples R ChinaShanghai Jiao Tong Univ Sch, Tong Ren Hosp, Peoples Hosp Hejian City, Shanghai, Peoples R ChinaPeking Univ, Shougang Hosp, Beijing, Peoples R ChinaGuangzhou Med Univ, Affiliated Hosp 3, Guangzhou, Guangdong, Peoples R ChinaSecond Hosp Nanchang, Nanchang, Jiangxi, Peoples R ChinaBethune Int Peace Hosp, Beijing, Peoples R ChinaHua Henan Prov Peoples Hosp, Beijing, Peoples R ChinaHua Henan Prov Peoples Hosp, Zhengzhou, Henan, Peoples R ChinaShanghai Jiao Tong Univ, Sch Med, Shanghai Ninth Peoples Hosp, Shanghai, Peoples R ChinaShijiazhuang Cent Hosp, Shijiazhuang, Hebei, Peoples R ChinaHosp Base San Jos de Osorno, Osorno, ChileChristian Med Coll & Hosp, Ludhiana, Punjab, IndiaUnit Narayana Hrudayalaya Ltd, Mazumdar Shaw Med Ctr, Bangalore, Karnataka, IndiaDr Ramesh Cardiac & Multispecial Hosp Pvt Ltd, Guntur, IndiaPost Grad Inst Med Educ & Res, Chandigarh, IndiaBaby Mem Hosp Ltd, Calicut, Kerala, IndiaSree Chitra Tirunal Inst Med Sci & Technol, Thiruvananthapuram, Kerala, IndiaSri Jayawardenepura Gen Hosp, Sri Jayawardenepura Kott, Sri LankaColombo North Teaching Hosp, Colombo, Sri LankaColombo South Coching Hosp, Colombo, Sri LankaLinkou Chang Gung Mem Hosp, Taoyuan, TaiwanTaipei Med Univ, Shuang Ho Hosp, Taipei, TaiwanEn Chu Kong Hosp, New Taipei, TaiwanNatl Cheng Kung Univ Hosp, Tainan, TaiwanQueen Alexandra Hosp, Portsmouth, Hants, EnglandPortsmouth Hosp NHS Natl Hlth Serv iTrust, Portsmouth, Hants, EnglandUniv Coll London Hosp NHS Fdn Trust, London, EnglandUniv Hosp Birmingham NHS Fdn Trust, Queen Elizabeth Hosp Birmingham, Birmingham, W Midlands, EnglandSouthend Univ Hosp NHS Fdn Trust, Southend On Sea, EnglandKings Coll Hosp London, London, EnglandYork Teaching Hosp NHS Fdn Trust, York, N Yorkshire, EnglandNottingham Univ Hosp NHS Trust, Nottingham, EnglandBlackpool Teaching Hosp NHS Fdn Trust, Blackpool, EnglandGloucestershire Hosp NHS Fdn Trust, Gloucestershire Royal Hosp, Gloucester, EnglandTeaching Hospi NHS Fdn Trust, London, EnglandRoyal Cornwall Hosp NHS Trust, Truro, EnglandRoyal London Hosp, Barts Hlth NHS Trust, London, EnglandSheffield Teaching Hosp NHS Fdn Trust, Sheffield, S Yorkshire, EnglandCambridge Univ Hosp NHS Fdn Trust, Addenbrookes Hosp, Cambridge, EnglandRoyal Victoria Hosp, Belfast Hlth & Social Care Trust, London, EnglandPinderfields Gen Hosp, Mid Yorkshire Hosp NHS Trust, Wakefield, EnglandRoyal Devon & Exeter NHS Fdn Trust, London, EnglandBradford Teaching Hosp NHS Fdn Trust, Bradford, W Yorkshire, EnglandGreat Western Hosp NHS Fdn Trust, Swindon, Wilts, EnglandWatford Dist Gen Hosp, Watford, EnglandImperial Coll Healthcare NHS Trust, London, EnglandMedway NHS Fdn Trust, Gillingham, EnglandRoyal Liverpool & Broadgreen Univ NHS Trust, Liverpool, Merseyside, EnglandCalderdale & Huddersfield NHS Fdn Trust, Huddersfield, W Yorkshire, EnglandHywel Dda Univ Hlth Board, Haverfordwest, WalesChesterfield Royal Hosp NHS Fdn Trust, Calow, EnglandLuton & Dunstable Univ Hosp NHS Fdn Trust, Luton, Beds, EnglandCountess Chester Hosp NHS Fdn Trust, Chester, Cheshire, EnglandPeterborough City Hosp, Peterborough, Cambs, EnglandUniv Hosp Leicester NHS Trust, Leicester Royal Infirm, Leicester, Leics, EnglandDist Hosp NHS Fdn Trust, London, EnglandBarnsley Hosp NHS Fdn Trust, Barnsley, EnglandDorset Cty Hosp NHS Fdn Trust, Dorchester, EnglandRoyal Bournemouth & Christchurch Hosp NHS Fdn Tru, Royal Bournemouth Hosp, Bournemouth, Dorset, EnglandSouthern Hlth & Social Care Trust, Craigavon Area Hosp, Portadown, EnglandUnited Lincolnshire Hosp NHS Trust, Pilgrim Hosp, Lincoln, EnglandBedford Hosp NHS Trust, Bedford, EnglandSao Paulo State Univ, Hosp Fac Med Botucatu, UNESP, Sao Paulo, BrazilNational Health and Medical Research Council of Australia: 106696