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Fractures, especially if articular and periarticular, are frequently associated to functional and clinical disabling outcomes and chronic pain. In particular, the injuries with loss of bone, ligament, and/or tendon tissue in which the full recovery of the wound area is not obtained are the worst anatomical/pathological conditions to heal. In this study, three different biological materials were used as regenerative approaches to rebuild the medial malleolus fracture of the ankle in which loss of bone, ligament, and tendon tissue occur. In particular, the morselized human bone tissue was combined with the human dermis decellularized, both augmented with homologous platelet-rich plasma. The magnetic resonance imaging study with contrast at the follow-up showed a signal compatible with vascularization of the tissue without sign of degeneration. Our new regenerative approach in which different biological materials were combined together showed a good choice of treatment for the reconstruction of not repairable outcome of a fracture.

Background We intended to verify through time-motion analysis the characteristics of the sequences of actions in terms of occurrence during water polo matches: number, duration, and possible relationships with technical-tactical aspects. Methods Water polo matches played at the 18th FINA World Championships 2019 were chosen for examination, and the analysis involved both single actions and Trains of Actions (ToAs). A ToA is a sequence of actions that occurs during the match without actual game interruption. Results A total of 1261 game actions were evaluated in the 17 matches analyzed. In 89% of cases the actions occurred in ToAs while in 11% of cases they took place as single actions. On average, each match included 74.4±5.3 actions; of these, only 7.9±3.4 (C.I. at 95%: lower bound 6.1 and upper bound 9.6) were single actions while 66.2±5.5 occurred in sequences (ToA2 = 29.6 ± 9.0%; ToA3 = 26.1 ± 9.7%; ToA4 = 16.5 ± 10.6%). The winning team performed on average more actions than the losing one (42.1±6.1 vs 32.0±6.4; effect size: 1.67; p value: 0.001). The ToAs had different compositions, from 2 to 18 actions, and then very different durations, from about 1 minute up to 8 minutes. 66% of goals were scored after ToAs and 34% after single actions. Conclusions The study of ToAs provides useful information on the physiological demand of the game, which may help to plan and organize physical training making it as specific as possible. The description of ToAs, can help coaches to better define the game scenario and understand which technical and tactical measures are needed to improve game organization.

BACKGROUND: The aim of this work was to compare anthropometric and general physical performance variables in young water polo athletes of three competitive levels, to identify the characteristic qualities and, therefore, the best variables for the identification of talent.METHODS: Fifty-seven young male water polo players between 12 and 14 years old were recruited for the study: 18 were recreational level (REC), 18 sub-elite level (SE) and 21 elite level (EL). To assess anthropometric characteristics the following measurements were used: body mass, height, waist circumference, hip circumference, chest circumference and arm span. Five general performance measures were used: counter movement jump (CMJ), triple hop jump (THJ), push up, chin up and sit up. Relative age was assessed.RESULTS: The whole sample was homogeneous by age (REC 13.1 +/- 0.4, SE 13.2 +/- 1.0, EL 13.3 +/- 0.7 years old) but not in terms of relative age: most of the members of the SE and EL groups were born in the first half of the year. Body mass values (REC 48.2 +/- 11.6, SE 59.3 +/- 11.6, EL 69.1 +/- 4.2 kg) show statistically significant differences between all three competitive levels (REC vs. SE P=0.007, REC vs. EL P=0.001, SE vs. EL P=0.009). As regards the other anthropometric measurements differences were mainly observed between REC and the two other groups: SE and EL had statistically significant higher values in almost all of the measurements carried out. Among the performance measures, lower limb strength (CMJ and THJ) seems to better differentiate between groups: REC group had lower values than the others and EL had the highest values.CONCLUSIONS: Anthropometric characteristics are useful to distinguish the basic level of youth categories from higher competitive levels and should be used for talent selection. The performance results confirm that the subjects' capacity to be trained and sporting practice are essential to reach the elite level.

Elite water polo athletes undergo heavy training programs throughout the year, but especially to prepare major competitions, such as the Olympic Games (OG). Optimal athletic performance is a result of many factors, including proper management of the intensity and volume of training, nutrition and recovery between training sessions. When training is excessive in relation to recovery may occur nonfunctional overreaching (NFO). NFO can degenerate into overtraining syndrome resulting in a decrease in athletic performance, with likely changes in body weight and body composition. The aim of this study was to evaluate the relationship between body composition and the tolerance to intense training supported by diet meal plans and to highlight any difference between athletes selected for the OG and not selected ones.Twenty-one male elite water polo athletes, 26 to 34 years of age, participated in the study. For three months before the Olympics, athletes have carried out an intense training period based on a detailed program. Only 13 athletes participated to OG (OA), 8 were excluded (NOA). Body weight and height were measured and Body Mass Index was calculated. BC and phase angle was evaluated at the half of first (T0), second (T1), and third (T2) month of training. Also blood analyses were collected at T0 and food intake assessed in all the evaluations. Measurements were carried out at three selected time points throughout the training period (12 weeks), which marked variations in the volume and intensity of the training load.Data analyses showed no statistical difference among the three measurements performed for body weight, body composition and phase angle in all OA group. Furthermore, there was not statistically significant differences between the OA and NOA group for weight, body mass index, body composition and phase angle.Results of the present study encourage the use of body composition by bioelectrical impedance monitoring system for high-level athletes involved in long and intense training periods to prevent body dehydration and overtraining syndrome. Body cell mass monitoring provides a valuable help to evaluate the effects of training and to prevent any decrease in the performance level.

In order to examine the physical and physiological demands of water polo, we assessed the profile of elite water polo players. Nineteen male professional water polo players (age: 25.5+/-5.0 years, height: 184.5+/-4.3 cm body mass: 90.7+/-6.4 kg) underwent body composition assessment by dual-energy X-ray absorptiometry. We also evaluated peak oxygen consumption VO2peak, lactate threshold (LT), energy cost of swimming (C s), anaerobic capacity and isokinetic shoulder strength. Body fat (%) was 16.8+/-4.4, lean mass (LM) 75.1+/-4.9 kg and bone mineral density (BMD) 1.37+/-0.07 g.cm(-2) . VO2peak was 57.9+/-7 ml.kg(-1). min(-1) . LT was identified at 3.9+/-0.7 mmol.l(-1) at a swimming velocity (v) of 1.33+/-0.05 m.s(-1) with a heart rate of 154+/-7 bpm, corresponding to an intensity of 83+/-9 of VO2peak. The average C s of swimming at the LT was 1.08+/-0.04 kJ.m(-1).C s at LT was correlated to body mass index (BMI) (r=0.22, P=0.04) and to swimming performance at 400 m (r=0.86, P=0.01) and 4 x 50 m (r=0.84, P