The impact of in-season national team soccer play on injury and player availability in a professional club

This study investigated the impact of in-season national team duty on injury rates and player availability in a professional soccer club. Time-loss injuries and exposure time during club and national team duties were recorded prospectively over 5 seasons (2009–2014). A time-loss injury was sustained by 37.7% of squad members participating in national duty, all injuries occurring in match-play. The incidence (per 1000 h exposure) for national team player match-play injuries did not differ (P = 0.608) to that for all players in club competitions: 48.0 (95% CI 20.9–75.5) vs. 41.9 (95% CI 36.5–47.4), incidence rate ratio = 1.2 (CI: 0.8–2.4). The majority (58%) of national team injuries resulted in a layoff ≤1 week. Of all working days lost to injury generally, 5.2% were lost through injury on national duty. Injury incidence in the week following national duty was comparable (P = 0.818) in players participating or not: 7.8 (95% CI 3.6–12.0) vs. 7.1 (95% CI: 4.6–9.6), incidence rate ratio = 1.1 (CI: 0.7–2.7). While approximately 40% of participating players incurred a time-loss injury on national duty, no training injuries were sustained and injuries made up a negligible part of overall club working days lost to injury. Following duty, players had a similar injury risk to peers without national obligations

Interpreting physical performance in professional soccer match-play: Should we be more pragmatic in our approach?

Academic and practitioner interest in the physical performance of male professional soccer players in the competition setting determined via time-motion analyses has grown substantially over the last four decades leading to a substantial body of published research and aiding development of a more systematic evidence-based framework for physical conditioning. Findings have forcibly shaped contemporary opinions in the sport with researchers and practitioners frequently emphasising the important role that physical performance plays in match outcomes. Time-motion analyses have also influenced practice as player conditioning programmes can be tailored according to the different physical demands identified across individual playing positions. Yet despite a more systematic approach to physical conditioning, data indicate that even at the very highest standards of competition, the contemporary player is still susceptible to transient and end-game fatigue. Over the course of this article, the author suggests that a more pragmatic approach to interpreting the current body of time-motion analysis data and its application in the practical setting is nevertheless required. Examples of this are addressed using findings in the literature to examine: a) the association between competitive physical performance and ‘success’ in professional soccer, b) current approaches to interpreting differences in time-motion analysis data across playing positions and, c) whether data can realistically be used to demonstrate the occurrence of fatigue in match-play. Gaps in the current literature and directions for future research are also identified

Women’s Experiences of Using Patient Portals in Healthcare Settings: A Rapid Review

Abstract Background The integration of patient portals into health systems has the potential to increase access for women. For example, within a mental health context, women are at a higher risk of developing anxiety and depression but may experience barriers in accessing care. Therefore, the aim of this rapid review was to understand what is currently known about patient portal use among women. The objectives were (1) To discover pertinent facilitators for women when using patient portals; (2) To discern if women face individual barriers to accessing patient portals; and (3) To explore the potential role of patient portals for women’s mental health care. Methods A rapid review methodology was implemented using the Cochrane Rapid Reviews Methods Group, as well as a grey literature scan. Inclusion criteria included articles that focused on women’s use of patient portals within healthcare settings. Four databases were searched, including Embase, MEDLINE (Ovid), CINAHL and PsycINFO in September 2023. Two independent reviewers performed screening, data extraction, and analysis. Results This search resulted in screening 1385 titles and abstracts, and 82 articles for full-text eligibility. 15 articles were included in the review. Data were extracted and analyzed, guided by the research objectives. Facilitators to patient portal use included processes that enhanced user engagement, the provision of portal tools, and management of health care features. Barriers included health equity factors and use of medical jargon. Applications to mental health care included how use of portals eased women’s anxiety and increased their sense of internal control. Conclusions The results of this review indicate that interrelated factors influence women’s experiences with using patient portals. By understanding facilitators and barriers to portal use, and applications for mental health care, we can understand how to improve women’s use of portals in the future

Monitoring Fatigue During the In-Season Competitive Phase in Elite Soccer Players.

Purpose:To quantify the relationship between daily training load and a range of potential measures of fatigue in elite soccer players during an in-season competitive phase (17 d).Methods:Total high-intensity-running (THIR) distance, perceived ratings of wellness (fatigue, muscle soreness, sleep quality), countermovement-jump height (CMJ), postexercise heart-rate recovery (HRR), and heart-rate variability (Ln rMSSD) were analyzed during an in-season competitive period (17 d). General linear models were used to evaluate the influence of daily fluctuation in THIR distance on potential fatigue variables.Results:Fluctuations in fatigue (r = −.51, large, P &lt; .001), Ln rMSSD (r = −.24, small, P = .04), and CMJ (r = .23, small, P = .04) were significantly correlated with fluctuations in THIR distance. Correlations between variability in muscle soreness, sleep quality, and HRR and THIR distance were negligible and not statistically significant.Conclusions:Perceived ratings of fatigue and Ln rMSSD were sensitive to daily fluctuations in THIR distance in a sample of elite soccer players. Therefore, these particular markers show promise as simple, noninvasive assessments of fatigue status in elite soccer players during a short in-season competitive phase.</jats:sec

Monitoring Fatigue During the In-Season Competitive Phase in Elite Soccer Players.

Purpose: To quantify the relationship between daily training load and a range of potential measures of fatigue in elite soccer players during an in-season competitive phase (17-days). Methods: Total high-intensity running distance (THIR), perceived ratings of wellness (fatigue, muscle soreness, sleep quality), counter-movement jump height (CMJ), post-exercise heart rate recovery (HRR) and heart rate variability (Ln rMSSD) were analysed during an in-season competitive period (17 days). General linear models were used to evaluate the influence of daily fluctuation in THIR distance on potential fatigue variables. Results: Fluctuations in fatigue (r=-0.51; large; P&lt;0.001), Ln rMSSD (r=-0.24; small; P=0.04), and CMJ (r=0.23; small; P=0.04) were significantly correlated with fluctuations in THIR distance. Correlations between variability in muscle soreness, sleep quality and HRR and THIR distance were negligible and not statistically significant. Conclusions: Perceived ratings of fatigue and heart rate variability were sensitive to daily fluctuations in THIR distance in a sample of elite soccer players. Therefore, these particular markers show particular promise as simple, non-invasive assessments of fatigue status in elite soccer players during a short in-season competitive phase

Monitoring of post-match fatigue in professional soccer: Welcome to the real world

Participation in soccer match-play leads to acute and transient subjective, biochemical, metabolic and physical disturbances in players over subsequent hours and days. Inadequate time for rest and regeneration between matches can expose players to the risk of training and competing whilst not entirely recovered. In professional soccer, contemporary competitive schedules can require teams to compete in-excess of 60 matches over the course of the season while periods of fixture congestion occur prompting much attention from researchers and practitioners to the monitoring of fatigue and readiness to play. A comprehensive body of research has investigated post-match acute and residual fatigue responses. Yet the relevance of the research for professional soccer contexts is debatable notably in relation to the study populations and designs employed. Monitoring can indeed be invasive, expensive, time-inefficient and difficult to perform routinely and simultaneously in a large squad of regularly competing players. Uncertainty also exists regarding the meaningfulness and interpretation of changes in fatigue response values and their functional relevance, and practical applicability in the field. The real-world need and cost-benefit of monitoring must be carefully weighed up. In relation to professional soccer contexts, this opinion paper intends to: 1) debate the need for PMF monitoring, 2) critique the real-world relevance of the current research literature, 3) discuss the practical burden relating to measurement tools and protocols and the collection, interpretation and application of data in the field, and, 4) propose future research perspectives

The acute-to-chronic workload ratio:An inaccurate scaling index for an unnecessary normalisation process?

An important question for researchers and practitioners is whether an individual’s risk of injury increases if they make prior changes to their training load.1 In this field of research, ‘load’ typically refers to in-training distances covered, speed and accelerations.1 Attention has generally focused on whether a person’s acute (eg, 7 day) increase in load, normalised to that person’s prior ‘baseline’ of chronic (eg, 28 day) load, predicts injury.1 To obtain this normalised predictor, acute load is typically divided by chronic load to provide the acute-to-chronic workload ratio (ACWR).1 Fundamentally, simple ratios (Y/X) are formulated to ‘ control for ’ a denominator variable (eg, preceding chronic load) that is perceived to have an important biological influence on the numerator variable (eg, acute load).2 Within this notion of ‘ control for ’,3 it is generally posited that the denominator is a ‘nuisance’ variable that is associated with the numerator of interest.2 Logically, a simple ratio index provides meaningful relative measures for clinical and prognostic purposes only if (1) there is a ‘true’ and ‘proportional’ association between numerator and denominator in the first place, and (2) the ratio normalises for the denominator in a consistent manner for all individuals in the measurement range.2 We have demonstrated recently that the typical practice in the current literature1 of including,

Cognitive Function in Children With Type 1 Diabetes: A meta-analysis

OBJECTIVE—To quantify the magnitude and pattern of cognitive difficulties in pediatric type 1 diabetes as well as the effects associated with earlier disease onset and severe hypoglycemia