Latest research in football - week 8 - 2017

#1 Mixed pathologies including chronic traumatic encephalopathy account for dementia in retired association football (soccer) players
Reference: Acta Neuropathol. 2017 Feb 15. doi: 10.1007/s00401-017-1680-3. [Epub ahead of print]
Authors: Ling H, Morris HR, Neal JW, Lees AJ, Hardy J, Holton JL, Revesz T, Williams DD
Summary: In retired professional association football (soccer) players with a past history of repetitive head impacts, chronic traumatic encephalopathy (CTE) is a potential neurodegenerative cause of dementia and motor impairments. From 1980 to 2010, 14 retired footballers with dementia were followed up regularly until death. Their clinical data, playing career, and concussion history were prospectively collected. Next-of-kin provided consent for six to have post-mortem brain examination. Of the 14 male participants, 13 were professional and 1 was a committed amateur. All were skilled headers of the ball and had played football for an average of 26 years. Concussion rate was limited in six cases to one episode each during their careers. All cases developed progressive cognitive impairment with an average age at onset of 63.6 years and disease duration of 10 years. Neuropathological examination revealed septal abnormalities in all six post-mortem cases, supportive of a history of chronic repetitive head impacts. Four cases had pathologically confirmed CTE; concomitant pathologies included Alzheimer's disease (N = 6), TDP-43 (N = 6), cerebral amyloid angiopathy (N = 5), hippocampal sclerosis (N = 2), corticobasal degeneration (N = 1), dementia with Lewy bodies (N = 1), and vascular pathology (N = 1); and all would have contributed synergistically to the clinical manifestations. The pathological diagnosis of CTE was established in four individuals according to the latest consensus diagnostic criteria. This finding is probably related to their past prolonged exposure to repetitive head impacts from head-to-player collisions and heading the ball thousands of time throughout their careers. Alzheimer's disease and TDP-43 pathologies are common concomitant findings in CTE, both of which are increasingly considered as part of the CTE pathological entity in older individuals. Association football is the most popular sport in the world and the potential link between repetitive head impacts from playing football and CTE as indicated from our findings is of considerable public health interest. Clearly, a definitive link cannot be established in this clinico-pathological series, but our findings support the need for further systematic investigation, including large-scale case-control studies to identify at risk groups of footballers which will justify for the implementation of protective strategies.


#2 Head accelerations across collegiate, high school and youth female and male soccer players
Reference: Br J Sports Med. 2017 Feb 16. pii: bjsports-2016-097118. doi: 10.1136/bjsports-2016-097118. [Epub ahead of print]
Authors: Caccese JB


#3 Surgical Management of Rectus Femoris Avulsion Among Professional Soccer Players
Reference: Orthop J Sports Med. 2017 Jan 23;5(1):2325967116683940. doi: 10.1177/2325967116683940. eCollection 2017.
Authors: Sonnery-Cottet B, Barbosa NC, Tuteja S, Gardon R, Daggett M, Monnot D, Kajetanek C, Thaunat M
Download link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5298416/pdf/10.1177_2325967116683940.pdf
Summary: Rectus femoris injuries are common among athletes, especially in kicking sports such as soccer; however, proximal rectus femoris avulsions in athletes are a relatively rare entity. The purpose of this study was to describe and report the results of an original technique of surgical excision of the proximal tendon remnant followed by a muscular suture repair. Our hypothesis was that this technique limits the risk of recurrence in high-level athletes and allows for rapid recovery without loss of quadriceps strength. Our retrospective series included 5 players aged 31.8 ± 3.9 years with acute proximal rectus femoris avulsion injuries who underwent a surgical resection of the proximal tendon between March 2012 and June 2014. Four of these players had recurrent rectus femoris injuries in the 9 months before surgery, while 1 player had surgery after a first injury. Mean follow-up was 18.2 ± 12.6 months, and minimum follow-up was 9 months. We analyzed the age, sex distribution, physical examination outcomes, type and mechanism of injury, diagnosis, treatment and complications during surgery, postoperative follow-up, and time to return to play. The Lower Extremity Functional Scale (LEFS) and Marx scores were obtained at 3-month follow-up, and isokinetic tests were performed before return to sports. A telephone interview was completed to determine the presence of recurrence at an average follow-up of 18.2 months. At 3-month follow-up, all patients had Marx activity scores of 16 and LEFS scores of 80. Return to the previous level of play occurred at a mean of 15.8 ± 2.6 weeks after surgery, and none of the athletes suffered a recurrence. Isokinetic test results were comparable between both sides. The surgical treatment of proximal rectus femoris avulsions, consisting of resection of the tendinous part of the muscle, is a reliable and safe technique allowing a fast recovery in professional athletes.


#4 A Comparison of Players' and Coaches' Perceptions of the Coach-Created Motivational Climate within Youth Soccer Teams
Reference: Front Psychol. 2017 Feb 1;8:109. doi: 10.3389/fpsyg.2017.00109. eCollection 2017.
Autors: Mollerlokken NE, Loras H, Pedersen AV
Download link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5285385/pdf/fpsyg-08-00109.pdf
Summary: The coach-created motivational climate within youth sports teams has been shown to be of great importance for the quality of youths' sports experiences as well as their motivation for continuing or discontinuing sport participation. While the player's perspective on motivational climates has been studied extensively, the coach's perspective has received considerably less attention. Thus, little is known about the concordance of perceptions of the motivational climate between coaches and their players, or the lack thereof. The purpose of the present study was to directly compare players' and coaches' perceptions of the motivational climate within their respective teams. To this end, 256 male and female soccer players (15-17 years of age) from 17 different teams and their coaches (n = 29) responded to the Perceived Motivational Climate in Sports Questionnaire-2 (PMCSQ-2). The study design included responses from both coaches and players to the same questionnaire, and both groups were aware of the other part's participation. Statistical analyses revealed significant differences between players' and coaches' perceptions of the motivational climate. Specifically, players of both sexes perceived the motivational climate to be significantly more performance-oriented and significantly less mastery-oriented compared with the coaches. These findings may advance our understanding of the coach-athlete relationship, and may be of importance for understanding players' motivation for persistence or discontinuation of the sport.


#5 Left ventricular longitudinal strain in soccer referees
Reference: Oncotarget. 2017 Feb 9. doi: 10.18632/oncotarget.15242. [Epub ahead of print]
Authors: Gianturco L, Bodini B, Gianturco V, Lippo G, Solbiati A, Turiel M
Download link: www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=download&path%5B%5D=15242&path%5B%5D=48739
Summary: Along the years, the analysis of soccer referees perfomance has interested the experts and we can find several types of studies in literature using in particular cardiac imaging. The aim of this retrospective study was to observe relationship between VO2max uptake and some conventional and not-conventional echocardiographic parameters. In order to perform this evaluation, we have enrolled 20 referees, belonging to Italian Soccer Referees' Association and we have investigated cardiovascular profile of them. We found a strong direct relationship between VO2max and global longitudinal strain of left ventricle assessed by means of speckle tracking echocardiographic analysis (R2=0.8464). The most common classic echocardiographic indexes have showed mild relations (respectively, VO2max vs EF: R2=0.4444; VO2max vs LV indexed mass: R2=0.2268). Therefore, our study suggests that longitudinal strain could be proposed as a specific echocardiographic parameter to evaluate the soccer referees performance.


#6 Short- or long-rest intervals during repeated-sprint training in soccer?
Reference: PLoS One. 2017 Feb 15;12(2):e0171462. doi: 10.1371/journal.pone.0171462. eCollection 2017
Authors: Iaia FM, Fiorenza M, Larghi L, Alberti G, Millet GP, Girard O
Download link: http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0171462&type=printable
Summary: The present study compared the effects of two repeated-sprint training (RST) programs, differing in duration of the between-sprint rest intervals, on various soccer-related exercise performances. For 5 weeks during the competitive season, twenty-nine young trained male soccer players either replaced two of their habitual fitness conditioning sessions with RST characterized by short (5-15; n = 9) or long (5-30; n = 10) rest intervals, or served as control (n = 10). The 5-15 and 5-30 protocols consisted of 6 repetitions of 30-m (~5 s) straight-line sprints interspersed with 15 s or 30 s of passive recovery, respectively. 5-15 improved 200-m sprint time (2.0±1.5%; p<0.05) and had a likely positive impact on 20-m sprint performance, whereas 5-30 lowered the 20-m sprint time (2.7±1.6%; p<0.05) but was only possibly effective for enhancing the 200-m sprint performance. The distance covered during the Yo-Yo Intermittent Recovery Test Level 2 increased following 5-15 (11.4±5.0%; p<0.05), which was possibly better than the non-significant 6.5% enhancement observed in 5-30. Improvements in the total time of a repeated-sprint ability test were possibly greater following 5-30 (3.6±0.9%; p<0.05) compared to 5-15 (2.6±1.1%; p<0.05). Both RST interventions led to similar beneficial (p<0.05) reductions in the percentage decrement score (~30%) of the repeated-sprint ability test as well as in blood lactate concentration during submaximal exercise (17-18%). No changes occurred in the control group. In soccer players, RST over a 5-week in-season period is an efficient means to simultaneously develop different components of fitness relevant to match performance, with different benefits induced by shorter compared to longer rest intervals.


#7 Relationship between field tests and match running performance in high-level young brazilian soccer players
Reference: J Sports Med Phys Fitness. 2017 Feb 14. doi: 10.23736/S0022-4707.17.06651-8. [Epub ahead of print]
Authors: Aquino R, Palucci Vieira LH, de Paula Oliveira L, Cruz Goncalves LG, Pereira Santiago PR
Summary: The main aim of this study was to analyse the relationship between field tests and match running performance using computational tracking technology in high-level young Brazilian soccer players. Twenty-five young male Brazilian soccer players participated in this study (U-15, n = 13; U-17, n = 12). In the same week the players were submitted to field tests and actual matches. The field tests were: Maximum Speed (10m-30m), Zig-Zag, Running-based Anaerobic Sprint Test, and Yo-Yo Intermittent Recovery Test level 1. Additionally, participants performed actual soccer match-play. Match running performance was collected using a fixed video-camera. Subsequently, computerized tracking video-analysis (30 Hz) was utilized to identify each physical performance indicator. Pearson's correlation and linear regression were used for statistical analysis. The results showed that the majority of field tests were not related to match running performance. The Zig-Zag Test, Running-based Anaerobic Sprint Test, and Yo-Yo Intermittent Recovery Test level 1 seem to be the most specific tests (r = 0.41-0.47), however the explanatory powers of these field tests in relation to match running performance were low (R2 = 17-22%). Assessment of match running performance should be included in the evaluation periods of young soccer players, together with the most specific tests reported.


#8 Role of vision in sighted and blind soccer players in adapting to an unstable balance task
Reference: Exp Brain Res. 2017 Feb 14. doi: 10.1007/s00221-017-4885-8. [Epub ahead of print]
Authors: Campayo-Piernas M, Caballero C, Barbado D, Reina R
Summary: This study tested whether a compensatory hypothesis exists on postural control during standing unstable balance tasks comparing blind soccer players (n = 7) to sighted soccer players (n = 15) and sighted sedentary individuals (n = 6). All subjects performed a pre-test, a training of ten practice trials on a single day, and a post-test balance test. All tests were performed on an unstable surface placed on a force platform and under closed-eyes conditions, and a final test was performed with open eyes. Balance performance was assessed by resultant distance (RD) and the magnitude of mean velocity (MV) of the centre of pressure (CoP) displacement, and EMG signals from the gastrocnemius lateralis, tibialis anterior, rectus femoris, and peroneus longus were measured with surface electromyography. Principal component analysis (PCA) on EMG muscular activation was used to assess EMG pattern differences during the balance tasks. All groups improved their performance, obtaining low scores for the closed-eyes condition balance task after the training period in RD, VM, and aids received to keep balance in the novel task, and no differences were found between groups or in interaction effects. Sighted individuals and the control group showed significantly lower RD and VM scores under open-eyes conditions than blind participants. As regards neuromuscular behaviour, three principal patterns explained 84.15% of the variability in the measured data. The theoretical improvement of the other senses caused by visual deprivation does not allow blind individuals to obtain better balance than sighted individuals under closed-eyes conditions, thereby reinforcing the prominent role of vision in integrating and processing the other sensory inputs. In addition, blind individuals seem to increase their muscular co-activation as a safety strategy, but this behaviour is not different to that shown by sighted people under closed-eyes conditions.


#9 Neuromuscular Coordination Deficit Persists 12 Months after ACL Reconstruction But Can Be Modulated by 6 Weeks of Kettlebell Training: A Case Study in Women's Elite Soccer
Reference: Case Rep Orthop. 2017;2017:4269575. doi: 10.1155/2017/4269575. Epub 2017 Jan 18.
Authors: Zebis MK, Andersen CH, Bencke J, Orntoft C, Linnebjerg C, Holmich P, Thorborg K, Aagaard P, Andersen LL
Download link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5286491/pdf/CRIOR2017-4269575.pdf
Summary: The aim of the present single-case study was to investigate the effect of 6 weeks' kettlebell training on the neuromuscular risk profile for ACL injury in a high-risk athlete returning to sport after ACL reconstruction. A female elite soccer player (age 21 years) with no previous history of ACL injury went through neuromuscular screening as measured by EMG preactivity of vastus lateralis and semitendinosus during a standardized sidecutting maneuver. Subsequently, the player experienced a noncontact ACL injury. The player was screened again following postreconstruction rehabilitation, then underwent 6-week kettlebell training, and was subsequently screened again at 6-week follow-up. Prior to and after postreconstruction rehabilitation the player demonstrated a neuromuscular profile during sidecutting known to increase the risk for noncontact ACL injury, that is, reduced EMG preactivity for semitendinosus and elevated EMG preactivity for vastus lateralis. Subsequently, the 6-week kettlebell training increased semitendinosus muscle preactivity during sidecutting by 38 percentage points to a level equivalent to a neuromuscular low-risk profile. An ACL rehabilitated female athlete with a high-risk neuromuscular profile changed to low-risk in response to 6 weeks of kettlebell training. Thus, short-term kettlebell exercise with documented high levels of medial hamstring activation was found to transfer into high medial hamstring preactivation during a sidecutting maneuver.


#10 Explosive strength and endurance adaptations in young elite soccer players during two soccer seasons
Reference: PLoS One. 2017 Feb 13;12(2):e0171734. doi: 10.1371/journal.pone.0171734. eCollection 2017.
Authors: Di Giminiani R, Visca C
Download link: http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0171734&type=printable
Summary: The purpose of the present study was to investigate the explosive strength and endurance adaptations in young elite soccer players who underwent a supervised training program for a period of two years. Nineteen players, with seven years of training experience (age: 13.3 ± 0.1 years; body weight: 57.9 ± 4.9 kg; height: 168.9 ± 4.7 cm; BMI: 20.1 ± 1.1 kg/m2), voluntarily participated in the present study. The testing sessions were performed at the beginning of the preparation period in the first (T1), second (T2), and third year (T3). The following performance variables were measured: explosive strength [squat-jump (SJ) and counter-movement-jump (CMJ)], pre-stretch augmentation (CMJ-SJ), leg stiffness [hopping test (HT)], short sprint performance [15 m (SSP15) and 30 m (SSP30)], aerobic endurance [test of Leger (VO2max)], maximal heart rate [at the last step of Leger (HR)], and speed-strength endurance [continuous counter-movement-jumps (CCMJ)]. A significant main effect on the VO2Max (+5.72%; F(2.49) = 3.822; p = 0.029; ES = 1.00), HR (-1.70%; F(2.54) = 3.472; p = 0.038; ES = 0.97), CCMJ (+7.64%; F(2.54) = 5.438; p = 0.007; ES = 1.15), SJ (+10.26%; F(2.54) = 15.254; p = 0.0001; ES = 1.53), CMJ (+7.36; F(2.54) = 8.270; p = 0.001; ES = 1.33), HT (+8.34%; F(2.48) = 3.297; p = 0.046; ES = 1.01), SSP15 (-3.50%; F(2.44) = 12.760; p = 0.0001; ES = 1.53), and SSP30 (-4.44%; F(2.44) = 5.797; p = 0.006; ES = 1.16) was observed in the two soccer seasons. These results highlight that, in long-term training, the monitoring of the adaptive responses in relation to the training load may provide a guideline to optimize the trainability of some performance variables in young elite soccer players (13-15 years). In the present study, we cannot exclude the influence of growth and maturation on some performance variables; therefore, the monitored adaptive responses should be considered as the possible results of an interaction between the applied training load and maturation.


#11 Higher Drop in Speed during a Repeated Sprint Test in Soccer Players Reporting Former Hamstring Strain Injury
Reference: Front Physiol. 2017 Jan 27;8:25. doi: 10.3389/fphys.2017.00025. eCollection 2017.
Authors: Roksund OD, Kristoffersen M, Bogen BE, Wisnes A, Engeseth MS, Nilsen AK, Iversen VV, Maland S, Gundersen H
Download link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5271334/pdf/fphys-08-00025.pdf
Summary: The aim of the study was to evaluate the physical capacity of players who have and have not suffered from hamstring strain injury in a sample of semi-professional and professional Norwegian soccer players in order to evaluate characteristics and to identify possible indications of insufficient rehabilitation. Seventy-five semi-professional and professional soccer players (19 ± 3 years) playing at the second and third level in the Norwegian league participated in the study. All players answered a questionnaire, including one question about hamstring strain injury (yes/no) during the previous 2 years. They also performed a 40 m maximal sprint test, a repeated sprint test (8 × 20 m), a countermovement jump, a maximal oxygen consumption (VO2max) test, strength tests and flexibility tests. Independent sample t-tests were used to evaluate differences in the physical capacity of the players who had suffered from hamstring strain injury and those who had not. Mixed between-within subject's analyses of variance was used to compare changes in speed during the repeated sprint test between groups. Players who reported hamstring strain injury during the previous two years (16%) had a significantly higher drop in speed (0.07 vs. 0.02 s, p = 0.007) during the repeated sprint test, compared to players reporting no previous hamstring strain injury. In addition, there was a significant interaction (groups × time) (F = 3.22, p = 0.002), showing that speed in the two groups changed differently during the repeated sprint test. There were no significant differences in relations to age, weight, height, body fat, linear speed, countermovement jump height, leg strength, VO2max, or hamstring flexibility between the groups. Soccer players who reported hamstring strain injury during the previous 2 years showed significant higher drop in speed during the repeated sprint test compared to players with no hamstring strain injury. The maximal speed, leg strength, ability to produce maximal power, endurance capacity, and hamstring flexibility was similar for both groups. Thus, a repeated sprint test consisting of 8 × 20 m could be used as a field-based diagnostic tool to identify players in need of reconditioning programs to ensure complete post-injury rehabilitation.


#12 Effect of low dose, short-term creatine supplementation on muscle power output in elite youth soccer players
Reference: J Int Soc Sports Nutr. 2017 Feb 7;14:5. doi: 10.1186/s12970-017-0162-2. eCollection 2017
Authors: Yanez-Silva A, Buzzachera CF, Picarro ID, Januario RS, Ferreira LH, McAnulty SR, Utter AC, Souza-Junior TP
Download link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296953/pdf/12970_2017_Article_162.pdf
Summary: The purpose of the study was to determine the effects of a low dose, short-term Creatine monohydrate (Cr) supplementation (0.03 g.kg.d-1 during 14 d) on muscle power output in elite youth soccer players. Using a two-group matched, double blind, placebo-controlled design, nineteen male soccer players (mean age = 17.0 ± 0.5 years) were randomly assigned to either Cr (N = 9) or placebo (N = 10) group. Before and after supplementation, participants performed a 30s Wingate Anaerobic Test (WAnT) to assess peak power output (PPO), mean power output (MPO), fatigue index (FI), and total work. There were significant increases in both PPO and MPO after the Cr supplementation period (P  ≤ 0.05) but not the placebo period. There were also significant increases in total work, but not FI, after the Cr supplementation and placebo periods (P ≤ 0.05). Notably, there were differences in total work between the Cr and placebo groups after (P ≤ 0.05) but not before the 14 d supplementation period. There is substantial evidence to indicate that a low-dose, short-term oral Cr supplementation beneficially affected muscle power output in elite youth soccer players.