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During cancer treatments in childhood hematological malignancies, reduced exercise tolerance is one of the main hardships. Precision-based training programs help children, adolescents, and young adults and their families to resume regular physical activity, exercise, and sports once they return to their communities after the intensive phases spent in hospital. This study was aimed at verifying whether an intermittent recovery test, the Yo-Yo AD, could provide a simple and valid way to evaluate an individual’s capacity to perform repeated intense exercise and to follow up on the impact of tailored exercise in children, adolescents, and young adults with hematological malignancies. The Yo-Yo AD involved the repetition of several shuttles to muscle exhaustion, at pre-established speeds (walking and slow running). The heart rate (HR) and oxygen saturation (SaO2) were monitored during the test. The total distance and the walking/running ability, measured as the slope of the HR vs. distance correlation, were investigated before (T0) and after 11 weeks (T1) of precision exercise intervention. The Yo-Yo AD was also performed by healthy children (CTRL). Ninety-seven patients (10.58 ± 4.5 years, 46% female) were enrolled. The Yo-Yo AD showed the positive impact of the exercise intervention by increasing the distance covered by the individuals (T0 = 946.6 ± 438.2 vs. T1 = 1352.3 ± 600.6 m, p < 0.001) with a more efficient walking/running ability (T0 = 2.17 ± 0.84 vs. T1 = 1.73 ± 0.89 slope, p < 0.0164). CTRLs performed better (1754.0 ± 444.0 m, p = 0.010). They were equally skillful (1.71 ± 0.27 slope) when compared to the patients after they received the precision-based intervention. No adverse events occurred during the Yo-Yo AD and it proved to be an accurate way of correctly depicting the changes in performance in childhood hematological malignancies.

Children and adolescents with haematological malignancies (PedHM) are characterized by a severe loss of exercise ability during cancer treatment, lasting throughout their lives once healed and impacting their social inclusion prospects. The investigation of the effect of a precision-based exercise program on the connections between systems of the body in PedHM patients is the new frontier in clinical exercise physiology. This study is aimed at evaluating the effects of 11 weeks (3 times weekly) of combined training (cardiorespiratory, resistance, balance and flexibility) on the exercise intolerance in PedHM patients. Two-hundred twenty-six PedHM patients were recruited (47% F). High or medium frequency participation (HAd and MAd) was considered when a participant joined; > 65% or between 30% and P 0.05), while the 6MWT and balance tests showed improvement only in HAd group (P 0.0001). These results support the ever-growing theory that, in the case of the treatment of PedHM, ‘exercise is medicine’ and it has the potential to increase the patient’s chances of social inclusion.

Return to play (RTP) decisions in football are currently based on expert opinion. No consensus guideline has been published to demonstrate an evidence-based decision-making process in football (soccer). Our aim was to provide a framework for evidence-based decision-making in RTP following lower limb muscle injuries sustained in football. A 1-day consensus meeting was held in Milan, on 31 August 2018, involving 66 national and international experts from various academic backgrounds. A narrative review of the current evidence for RTP decision-making in football was provided to delegates. Assembled experts came to a consensus on the best practice for managing RTP following lower limb muscle injuries via the Delphi process. Consensus was reached on (1) the definitions of ‘return to training’ and ‘return to play’ in football. We agreed on ‘return to training’ and RTP in football, the appropriate use of clinical and imaging assessments, and laboratory and field tests for return to training following lower limb muscle injury, and identified objective criteria for RTP based on global positioning system technology. Level of evidence IV, grade of recommendation D.

In his training and experiential path, the physical education (PE) teacher will be considered qualified and “competent”, only when he/she will be able to affect positively and effectively the educational relationship with the students by helping and leading them towards the acquisition of that particular form of intelligence, which from now on, we will call “body-kinesthetic” or “motor” intelligence. For a long time now, the concept of "competence" has been adopted within various fields and referred to different dimensions to indicate the level of ability to do something. For this reason, it is currently challenging to provide a univocal definition of competence since its meaning varies according to the context and the topic of the discussion. From an educational perspective, the PE teacher’s competence should not simply indicate his basic knowledge, intended as the sum of specific and sectorial knowledges consolidated though the experience, nor his teaching skills, intended as pure technical-professional skills. Indeed, a third indispensable component that has to be integrated in the concept of competence, can be identified in the individual character, attitude and personal traits of the teacher. Finally, a fourth component is the high success rate of the teaching and didactic process. Only the combination of these four distinct but related components, will qualify the teacher to deliver high quality teaching and to be considered “competent”.

Many studies and common practice use different load and recovery time combinations to obtain improvements in strength performance. The cross education and speech neurons theory could lead to new strategies in motor skills learning and in fitness improvement. Thus, the aim of this study was to verify if a process similar to cross education and visual phenomenon (reading approach) could improve the strength performance. The study consisted of three matched samples that followed three different protocols (strength training, mental and reading approach) and a control group. After 12 training sessions the improvements in maximal voluntary handgrip were assessed. On average, the improvement in handgrip performance was 3.02, 2.97, 2.07, 1.16 kg for strength, mental, reading and control sample respectively. Significant differences among groups were found while no differences were found before and after the protocol, as well as for the interaction. The post hoc analysis revealed significant differences between the strength sample (after training value) and the control group (before the training). Mental or reading training resulted in almost similar improvements that are close to strength training gains. Indeed, at least for the initial training session, the reading training was broadly similar to well-know protocol and could be used to provide complementary stimulus.

Introduction: The purpose of this study is to explore the values orientation of individuals (students and teachers) involved in Sport Science and Sport Pedagogy fields. The participants completed an ad-hoc prepared socio-anagraphic questionnaire and the PVQ (Portrait Values Questionnaire), a list of 40 item that describe the values of a general person and the subjects express how much they perceive themselves similar to the hypothetical person (in a Likert 6 points scale). Discussion: Individuals involved in physical activity seem to have a good social predisposition (prevalent values orientation of self-transcendence), especially those who chose a teaching career and are interested in other people’s wellbeing.

Patients with mitochondrial myopathies (MM) or myophosphorylase deficiency (McArdle's disease, McA) show impaired capacity for O(2) extraction, low maximal aerobic power, and reduced exercise tolerance. Non-invasive tools are needed to quantify the metabolic impairment. Six patients with MM, 6 with McA, 25 with symptoms of metabolic myopathy but negative biopsy (patient-controls, P-CTRL) and 20 controls (CTRL) underwent an incremental cycloergometric test. Pulmonary O(2) uptake (VO(2)) and vastus lateralis oxygenation indices (by near-infrared spectroscopy, NIRS) were determined. Concentration changes of deoxygenated hemoglobin and myoglobin (Delta[deoxy(Hb + Mb)]) were considered an index of O(2) extraction. Delta[deoxy(Hb + Mb)] peak (percent limb ischemia) was lower in MM (25.3 +/- 12.0%) and McA (18.7 +/- 7.3) than in P-CTRL (62.4 +/- 3.9) and CTRL (71.3 +/- 3.9) subjects. VO(2) peak and Delta[deoxy(Hb + Mb)] peak were linearly related (r(2) = 0.83). In these patients, NIRS is a tool to detect and quantify non-invasively the metabolic impairment, which may be useful in the follow-up of patients and in the assessment of therapies and interventions.

Soccer is among the most played and most popular sports in the world. The average incidence of injuries per game is 2.7 and that an adult soccer player has at least one injury per year (Roi G.S., Della Villa S., 2011). Findings from recent studies suggest that psychological factors such as somatic trait anxiety and daily hassles are associated with increased risk of injury (Johnson and Ivarsson, 2013). The purpose of this study was to examine the relationship between anxiety and injury in adult male soccer players. Method The participants of the study were 100 amauteur male soccer players (aged 18 to 45). Each player filled in a qualitative questionnaire about his personal characteristics and sport practice (training, matches, etc.) and previous injuries (muscle, meniscal, injuries, tendinopathies, fractures, etc.). The participants also completed the Stai–State-Trait Anxiety Inventory (Spielberger et al , 1968). This questionnaire investigates the anxiety level, both in a specific situation (before the match, in this study) and in everyday life. Results The data were tested for correlations between anxiety (state and trait) levels and number of injuries (divided in specific types). Tendinopathies positively correlated both with state (rho=0.243; p Differences in injuries between participants who reported high or low anxiety levels were also explored. Players with higher level of state anxiety (N=35) reported more tendinopathies (p Discussion The present results support the contention that anxiety is an important factor, significantly associated with injuries, such as tendinopathies and fractures. In addict, several studies have shown that lack of readiness to take action, tough-mindedness or presence of a generalized high status of muscle tone, might be factors related to injury in a player with anxiety traits. Hence, with respect to psychological components, situation-related emotional states and coping resources may represent important avenues for interventions aimed at preserving health status and preventing injuries in soccer players.

Porcelli S, Marzorati M, Lanfranconi F, Vago P, Pisot R, Grassi B. Role of skeletal muscles impairment and brain oxygenation in limiting oxidative metabolism during exercise after bed rest. J Appl Physiol 109: 101-111, 2010. First published April 15, 2010; doi:10.1152/japplphysiol.00782.2009.-"Central" and "peripheral" limitations to oxidative metabolism during exercise were evaluated in 10 young males following a 35-day horizontal bed rest (BR). Incremental exercise (IE) and moderate-and heavy-intensity constant-load exercises (CLE) were carried out on a cycloergometer before and 1-2 days after BR. Pulmonary gas exchange, cardiac output (Q.; by impedance cardiography), skeletal muscle (vastus lateralis), and brain (frontal cortex) oxygenation (by near-infrared spectroscopy) were determined. After BR, "peak" (values at exhaustion during IE) workload, peak O-2 uptake ((V) over dotO(2peak)), peak stroke volume, (Q) over dot(peak), and peak skeletal muscle O-2 extraction were decreased (-18, -18, -22, -19, and -33%, respectively). The gas exchange threshold was similar to 60% of (V) over dotO(2peak) both before and after BR. At the highest workloads, brain oxygenation data suggest an increased O-2 extraction, which was unaffected by BR. (V) over dotO(2) kinetics during CLE (same percentage of peak workload before and after BR) were slower (time constant of the "fundamental" component: 31.1 +/- 2.0 s before vs. 40.0 +/- 2.2 s after BR); the amplitude of the "slow component" was unaffected by BR, thus it would be greater, after BR, at the same absolute workload. A more pronounced "overshoot" of skeletal muscle O-2 extraction during CLE was observed after BR, suggesting an impaired adjustment of skeletal muscle O-2 delivery. The role of skeletal muscles in the impairment of oxidative metabolism during submaximal and maximal exercise after BR was identified. The reduced capacity of peak cardiovascular O-2 delivery did not determine a "competition" for the available O-2 between skeletal muscles and brain

Purpose: The aim was to identify additional noninvasive tools allowing to detect and to quantify the metabolic impairment in patients with mitochondrial myopathies (MM) or McArdle's disease (McA). Methods: Kinetics of adjustment of pulmonary oxygen uptake (V[spacing dot above]O2 kinetics) during transitions to constant-load moderate-intensity cycle ergometer exercise were determined on 15 MM, 8 McA, 21 patients with signs and/or symptoms of metabolic myopathy but a negative biopsy ("patient controls"; P-CTRL), and 22 healthy untrained controls (CTRL). Results: V[spacing dot above]O2 kinetics were slower in MM and in McA versus P-CTRL and CTRL, slower in McA versus MM, and not significantly different between P-CTRL and CTRL. The time constants ([tau]) of the monoexponential function describing the V[spacing dot above]O2 kinetics were (X[spacing macron] +/- SE) 59.2 +/- 8.5 s in MM, 87.6 +/- 16.4 s in McA, 36.9 +/- 3.1 s in P-CTRL, and 35.4 +/- 1.9 s in CTRL. In a subgroup of the patients (eight MM and seven McA), [tau] of V[spacing dot above]O2 kinetics were negatively correlated with two variables determined in a previous study (Grassi B, Marzorati M, Lanfranconi F, et al. Impaired oxygen extraction in metabolic myopathies: detection and quantification by near-infrared spectroscopy. Muscle Nerve. 2007;35:510-20): a) a muscle oxygenation index, obtained by near-infrared spectroscopy, estimating the peak capacity of skeletal muscle fractional O2 extraction; and b) V[spacing dot above]O2 peak. Conclusions: In MM and McA patients, analysis of pulmonary V[spacing dot above]O2 kinetics during moderate-intensity exercise allows to identify and to quantify, noninvasively, the impairment of skeletal muscle oxidative metabolism. In these patients, the slower V[spacing dot above]O2 kinetics can be considered a marker of the impaired exercise tolerance. The present data could be useful for clinicians who need an objective, quantitative, and longitudinal evaluation of the impairment to be used in the follow-up of these patients as well as in the assessment of therapeutic interventions