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Modena R, Togni A, Fanchini M, Pellegrini B, Schena F. Influence of pitch size and goalkeepers on external and internal load during small-sided games in amateur soccer players. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00766-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Abstract
Purpose
To analyse the influence of goalkeepers during 4-a-side small-sided games, played in pitches of two different sizes (small: 30 × 20 m, large: 40 × 30 m).
Methods
Total distance covered (TD), distance covered at low- (LSD), moderate- (MSD), high- (HSD) and very high-speed (VHSD), average and maximal speed, Edwards’ training load (Edw-TL), time spent above 90% of maximal heart rate (T90%) and rate of perceived exertion (RPE) were monitored, in 18 amateur soccer players.
Results
Higher TD (mean difference: + 181 m, Hedge’s g: 0.93 and + 400 m, 3.37), MSD (+ 85 m, 0.79 and + 146 m, 1.64), HSD (+ 101 m, 1.41 and + 179 m, 3.26), VHSD (+ 30 m, 1.89 and + 35 m, 1.26), average speed (+ 0.65 km h−1, 0.88 and + 1.47 km h−1, 3.31) and maximal speed (+ 3.60 km h−1, 1.40 and + 3.58 km h−1, 1.40) were found in large than small pitch, without and with goalkeepers, respectively. Goalkeeper’s presence increased Edw-TL (+ 8.4 AU, 0.70) and reduced TD (− 141 m, 0.75), HSD (− 54 m, 0.75) and average speed (− 0.54 km h−1, 0.76) in small pitch and maximal speed (1.59 km h−1, 0.60 and 1.61 km h−1, 0.66) in both small and large pitches, respectively. RPE was higher (+ 20, 1.52) in the large than small pitch when the goalkeepers were present.
Conclusion
Implementing small-sided games, coaches should be aware that lower external load with similar internal load could be provided using small pitch with goalkeeper rather than either small goals or larger pitch. Furthermore, large small-sided games without goalkeeper may be the best choice for eliciting high training load.
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Gentilin A, Tam E, Tarperi C, Beccarello F, Cevese A, Schena F. Post-exercise upside-down recovery does accelerate the heart rate recovery but does not improve subsequent sprint performance. J Sports Med Phys Fitness 2021; 62:1045-1052. [PMID: 33885257 DOI: 10.23736/s0022-4707.21.12321-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Many recreational cyclists believe that lying upside-down after intense physical exertion speeds up physical recovery, enhancing subsequent exercise performance. However, the effectiveness of this technique has not yet been investigated. METHODS 25 active cyclists (10 females/15 males; age 23.3±3.8 years old) performed a supramaximal 45-sec Wingate test before and after a 7-min recovery period at +45° or -20° of inclination, randomly, in a two-day cross-over protocol. The percentage decline of post- compared to pre-recovery Wingate performance was used to assess the recovery effectiveness. Kinetics of lactate, heart rate (HR), and mean blood pressure (MBP) during recovery were considered as physiological indices of recovery. RESULTS 7 subjects (5 males) did not complete the +45° protocol due to pre-syncopal symptoms. The upside-down compared to the standing recovery did not change the subsequent Wingate performance, despite faster HR decline and cyclists' perception of better recovery. The upside-down recovery did not change the kinetics of lactate clearance but prevented the MBP fall. CONCLUSIONS Among subjects who fully completed the protocol, our data reveal the ineffectiveness of the upside-down recovery to enhance subsequent exercise performance, despite the faster HR decline and personal feeling of greater recovery may suggest that assumption. Such a better psychophysical feeling when upside-down compared to standing recovery may be associated with attenuation of post-exercise hypotension symptoms. This data suggest being cautious in basing the assessment of the athlete's recovery exclusively on the post-exercise kinetics of the HR.
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Poli S, Rimondini M, Gajofatto A, Mazzi MA, Busch IM, Gobbin F, Schena F, Del Piccolo L, Donisi V. "If You Can't Control the Wind, Adjust Your Sail": Tips for Post-Pandemic Benefit Finding from Young Adults Living with Multiple Sclerosis. A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084156. [PMID: 33919974 PMCID: PMC8070973 DOI: 10.3390/ijerph18084156] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 12/22/2022]
Abstract
The COVID-19 outbreak has impacted the wellbeing of people worldwide, potentially increasing maladaptive psychological responses of vulnerable populations. Although young adults with multiple sclerosis (yawMS) might be at greater risk of developing psychological distress linked to the pandemic, they might also be able to adapt to stress and find meaning in adverse life events. The aim of the present study was to explore benefit finding in response to the pandemic in a sample of yawMS. As part of a larger project, data were collected using a cross-sectional, web-based survey. Benefit finding was analysed using a qualitative thematic approach; descriptive and inferential statistics were performed to describe the sample and compare sub-groups. Out of 247 respondents with mostly relapsing-remitting MS, 199 (31.9 ± 6.97 years) reported at least one benefit. Qualitative analysis showed that during the pandemic yawMS found benefits related to three themes: personal growth, relational growth, and existential growth. No differences in benefit finding were found between age sub-groups (18–30 vs. 31–45). Participants reported a wide range of benefits, some of which seem to be specific to MS or the pandemic. Results have been transformed into tips to be introduced in clinical practice to promote resilience in yawMS through meaning making.
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Muollo V, Rossi AP, Milanese C, Zamboni M, Rosa R, Schena F, Pellegrini B. Prolonged unsupervised Nordic walking and walking exercise following six months of supervision in adults with overweight and obesity: A randomised clinical trial. Nutr Metab Cardiovasc Dis 2021; 31:1247-1256. [PMID: 33549445 DOI: 10.1016/j.numecd.2020.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS This study is a randomized trial that examined the effects of 6 months of unsupervised Nordic walking (NW) and walking (W) exercise following 6 months of supervised training in overweight/obese adults. METHODS AND RESULTS After a 6-month program of diet and supervised training participants (n = 27) of NW (66 ± 7 yrs, body mass index (BMI) 34 ± 5) and W (66 ± 8 yrs, BMI 32 ± 5) group continue the training without supervision for other 6 months. Steps count and mean heart rate (HRmean) were performed in each session; anthropometric and body composition, aerobic capacity and strength of the upper and lower limbs were evaluated at baseline, after 6 months of supervised and 6 months of unsupervised training. In the unsupervised training, monthly sessions and steps count decreased over time in both groups (p < 0.05), with no significant changes in HRmean. Compared to the supervised phase, adherence decreased significantly only in the W group in the last 3 months of unsupervised training. Compared to baseline in both groups BMI did not change, but W group lost total fat; only the NW group maintained (p < 0.05) the gains in arm curl (33%) and chair stand (31%); both groups improved in six-minute walking test (p < 0.05). CONCLUSION Despite unsupervised training was not effective for a further increase in performance, participants, especially in NW, maintained some of the improvements achieved during the supervision. However, the presence of instructor that guides training, may enhance adherence and health benefits of NW and W exercise. CLINICAL TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT03212391 (July 11, 2017).
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Callovini A, Fornasiero A, Savoldelli A, Stella F, Low DA, Pellegrini B, Schena F, Bortolan L. Effects of three-exercise sessions in the heat on endurance cycling performance. J Therm Biol 2021; 98:102925. [PMID: 34016347 DOI: 10.1016/j.jtherbio.2021.102925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/22/2021] [Accepted: 03/27/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the effects of a very short-term acclimation protocol (VSTAP) on performance, physiological and perceptual responses to exercise in the heat. METHODS 12 trained male cyclists (age 31.2 ± 7; weight 71.3 ± 7 kg, VO2max: 58.4 ± 3.7 mL/kg/min) randomly performed two Time to Exhaustion Tests (TTE) at 75% of normothermic peak power output (PPO), one in normothermia (N,18°C-50% RH) and one in the heat (H,35°C-50% RH), before and after a VSTAP intervention, consisting of 3 days-90 min exercise (10min at 30% of PPO+80 min at 50% of PPO) in H (≈4.5h of heat exposure). Performance time of TTEs and physiological and perceptual variables of both TTEs and training sessions (T1, T2 and T3) were evaluated. RESULTS Magnitude Based Inferences (MBI) revealed 92/6/1% and 62/27/11% chances of positive/trivial/negative effects of VSTAP of improving performance in H (+17%) and in N (+9%), respectively. Heart Rate (HR) decreased from T1 to T3 (p < 0.001) and T2 to T3 (p < 0.001), whereas Tympanic Temperature (TyT) decreased from T1 to T2 (p = 0.047) and from T1 to T3 (p = 0.007). Furthermore, despite the increased tolerance to target Power Output (PO) throughout training sessions, RPE decreased from T1 to T3 (p = 0.032). CONCLUSIONS The VSTAP determined meaningful physiological (i.e. decreased HR and TyT) and perceptual (i.e. decreased RPE) adaptations to submaximal exercise. Furthermore, showing good chances to improve performance in the heat, it represents a valid acclimation strategy to be implemented when no longer acclimation period is possible. Finally, no cross-over effect of the VSTAP on performance in temperate conditions was detected.
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Martignon C, Ruzzante F, Giuriato G, Laginestra FG, Pedrinolla A, Di Vico IA, Saggin P, Stefanelli D, Tinazzi M, Schena F, Venturelli M. The key role of physical activity against the neuromuscular deterioration in patients with Parkinson's disease. Acta Physiol (Oxf) 2021; 231:e13630. [PMID: 33595917 DOI: 10.1111/apha.13630] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 12/11/2022]
Abstract
AIM Decreased muscle strength has been frequently observed in individuals with Parkinson's disease (PD). However, this condition is still poorly examined in physically active patients. This study compared quadriceps (Q) maximal force and the contribution of central and peripheral components of force production during a maximal isometric task between physically active PD and healthy individuals. In addition, the correlation between force determinants and energy expenditure indices were investigated. METHODS Maximal voluntary contraction (MVC), resting twitch (RT) force, pennation angle (θp), physiological cross-sectional area (PCSA) and Q volume were assessed in 10 physically active PD and 10 healthy control (CTRL) individuals matched for age, sex and daily energy expenditure (DEE) profile. RESULTS No significant differences were observed between PD and CTRL in MVC (142 ± 85; 142 ± 47 N m), Q volume (1469 ± 379; 1466 ± 522 cm3 ), PCSA (206 ± 54; 205 ± 71 cm2 ), θp (14 ± 7; 13 ± 3 rad) and voluntary muscle-specific torque (MVC/PCSA [67 ± 35; 66 ± 19 N m cm-2 ]). Daily calories and MVC correlated (r = 0.56, P = .0099). However, PD displayed lower maximal voluntary activation (MVA) (85 ± 7; 95 ± 5%), rate of torque development (RTD) in the 0-0.05 (110 ± 70; 447 ± 461 N m s-1 ) and the 0.05-0.1 s (156 ± 135; 437 ± 371 N m s-1 ) epochs of MVCs, whereas RT normalized for PCSA was higher (35 ± 14; 20 ± 6 N m cm-2 ). CONCLUSION Physically active PDs show a preserved strength of the lower limb. This resulted by increasing skeletal muscle contractility, which counterbalances neuromuscular deterioration, likely due to their moderate level of physical activity.
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Laginestra FG, Amann M, Kirmizi E, Giuriato G, Barbi C, Ruzzante F, Pedrinolla A, Martignon C, Tarperi C, Schena F, Venturelli M. Electrically induced quadriceps fatigue in the contralateral leg impairs ipsilateral knee extensors performance. Am J Physiol Regul Integr Comp Physiol 2021; 320:R747-R756. [PMID: 33729017 DOI: 10.1152/ajpregu.00363.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Muscle fatigue induced by voluntary exercise, which requires central motor drive, causes central fatigue that impairs endurance performance of a different, nonfatigued muscle. This study investigated the impact of quadriceps fatigue induced by electrically induced (no central motor drive) contractions on single-leg knee-extension (KE) performance of the subsequently exercising ipsilateral quadriceps. On two separate occasions, eight males completed constant-load (85% of maximal power-output) KE exercise to exhaustion. In a counterbalanced manner, subjects performed the KE exercise with no pre-existing quadriceps fatigue in the contralateral leg on one day (No-PreF), whereas on the other day, the same KE exercise was repeated following electrically induced quadriceps fatigue in the contralateral leg (PreF). Quadriceps fatigue was assessed by evaluating pre- to postexercise changes in potentiated twitch force (ΔQtw,pot; peripheral fatigue), and voluntary muscle activation (ΔVA; central fatigue). As reflected by the 57 ± 11% reduction in electrically evoked pulse force, the electrically induced fatigue protocol caused significant knee-extensors fatigue. KE endurance time to exhaustion was shorter during PreF compared with No-PreF (4.6 ± 1.2 vs 7.7 ± 2.4 min; P < 0.01). Although ΔQtw,pot was significantly larger in No-PreF compared with PreF (-60% vs -52%, P < 0.05), ΔVA was greater in PreF (-14% vs -10%, P < 0.05). Taken together, electrically induced quadriceps fatigue in the contralateral leg limits KE endurance performance and the development of peripheral fatigue in the ipsilateral leg. These findings support the hypothesis that the crossover effect of central fatigue is mainly mediated by group III/IV muscle afferent feedback and suggest that impairments associated with central motor drive may only play a minor role in this phenomenon.
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Ronchi A, Pietrasanta C, Zavattoni M, Saruggia M, Schena F, Sinelli MT, Agosti M, Tzialla C, Varsalone FF, Testa L, Ballerini C, Ferrari S, Mangili G, Ventura ML, Perniciaro S, Spada E, Lunghi G, Piralla A, Baldanti F, Mosca F, Pugni L. Evaluation of Rooming-in Practice for Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Italy. JAMA Pediatr 2021; 175:260-266. [PMID: 33284345 PMCID: PMC7921895 DOI: 10.1001/jamapediatrics.2020.5086] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE The management of mother-infant dyads during the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic constitutes a major issue for neonatologists. In mothers with SARS-CoV-2 infection, current recommendations suggest either to separate the dyad or encourage protected rooming-in under appropriate precautions. No data are available regarding the risk of mother-to-infant transmission of SARS-CoV-2 during rooming-in. OBJECTIVE To evaluate the risk of postnatal transmission of SARS-CoV-2 from infected mothers to their neonates following rooming-in and breastfeeding. DESIGN, SETTING, AND PARTICIPANTS A prospective, multicenter study enrolling mother-infant dyads from March 19 to May 2, 2020, followed up for 20 days of life (range, 18-22 days), was performed. The study was conducted at 6 coronavirus disease 2019 maternity centers in Lombardy, Northern Italy. Participants included 62 neonates born to 61 mothers with SARS-CoV-2 infection who were eligible for rooming-in practice based on the clinical condition of the mother and infants whose results of nasopharyngeal swabs were negative at birth. EXPOSURES Mothers with SARS-CoV-2 infection were encouraged to practice rooming-in and breastfeeding under a standardized protocol to minimize the risk of viral transmission. MAIN OUTCOMES AND MEASURES Clinical characteristics and real-time reverse transcriptase-polymerase chain reaction for SARS-CoV-2 on neonatal nasopharyngeal swabs at 0, 7, and 20 days of life. RESULTS Of the 62 neonates enrolled (25 boys), born to 61 mothers (median age, 32 years; interquartile range, 28-36 years), only 1 infant (1.6%; 95% CI, 0%-8.7%) was diagnosed as having SARS-CoV-2 infection at postbirth checks. In that case, rooming-in was interrupted on day 5 of life because of severe worsening of the mother's clinical condition. The neonate became positive for the virus on day 7 of life and developed transient mild dyspnea. Ninety-five percent of the neonates enrolled were breastfed. CONCLUSIONS AND RELEVANCE The findings of this cohort study provide evidence-based information on the management of mother-infant dyads in case of SARS-CoV-2 maternal infection suggesting that rooming-in and breastfeeding can be practiced in women who are able to care for their infants.
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Martignon C, Pedrinolla A, Ruzzante F, Giuriato G, Laginestra FG, Bouça-Machado R, Ferreira JJ, Tinazzi M, Schena F, Venturelli M. Reply to the Letter "What does characterize exercise guidelines for Parkinson's disease?". Aging Clin Exp Res 2021; 33:677-678. [PMID: 33389712 DOI: 10.1007/s40520-020-01770-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 11/26/2022]
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Fornasiero A, Savoldelli A, Stella F, Callovini A, Bortolan L, Zignoli A, Low DA, Mourot L, Schena F, Pellegrini B. Response to Chaen and Trapellieni re: "Shortening Work-Rest Durations Reduces Physiological and Perceptual Load During Uphill Walking in Simulated Cold High-Altitude Conditions," by Fornasiero et al. High Alt Med Biol 2021; 22:105-106. [PMID: 33783236 DOI: 10.1089/ham.2020.0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Moghetti P, Balducci S, Guidetti L, Mazzuca P, Rossi E, Schena F, Moghetti P, Balducci S, Guidetti L, Schena F, Mazzuca P, Rossi E. Walking for subjects with type 2 diabetes: a systematic review and joint AMD/SID/SISMES evidence-based practical guideline. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-020-00690-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract
Aims
Regular exercise is considered a cornerstone in the management of type 2 diabetes mellitus (T2DM). It improves glucose control and cardiovascular risk factors, contributes to weight loss, and also improves general well-being, likely playing a role in the prevention of chronic complications of diabetes. However, compliance to exercise recommendations is generally inadequate in subjects with T2DM. Walking is the most ancestral form of physical activity in humans, easily applicable in daily life. It may represent, in many patients, a first simple step towards lifestyle changes. Nevertheless, while most diabetic patients do not engage in any weekly walking, exercise guidelines do not generally detail how to improve its use. The aims of this document are to conduct a systematic review of available literature on walking as a therapeutic tool for people with T2DM, and to provide practical, evidence-based clinical recommendations regarding its utilization in these subjects.
Data synthesis
Analysis of available RCTs proved that regular walking training, especially when supervised, improves glucose control in subjects with T2DM, with favorable effects also on cardiorespiratory fitness, body weight, and blood pressure. Moreover, some recent studies have shown that even short bouts of walking, used for breaking prolonged sitting, can ameliorate glucose profiles in diabetic patients with sedentary behavior.
Conclusions
There is sufficient evidence to recognize that walking is a useful therapeutic tool for people with T2DM. This document discusses theoretical and practical issues for improving its use.
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Donisi V, Gajofatto A, Mazzi MA, Gobbin F, Busch IM, Ghellere A, Klonova A, Rudi D, Vitali F, Schena F, Del Piccolo L, Rimondini M. A Bio-Psycho-Social Co-created Intervention for Young Adults With Multiple Sclerosis (ESPRIMO): Rationale and Study Protocol for a Feasibility Study. Front Psychol 2021; 12:598726. [PMID: 33708157 PMCID: PMC7940381 DOI: 10.3389/fpsyg.2021.598726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/18/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS), the most common neurological disease that causes disability in youth, does not only affect physical functions but is also associated with cognitive impairment, fatigue, depression, and anxiety and can significantly impact health-related quality of life (HRQoL). Since MS is generally diagnosed at a young age-a period of great significance for personal, relational, and professional development-adaptation can become highly challenging. Therefore, enhancing the competence of young people to adaptively cope with these potential challenges is of utmost importance in order to promote their potentialities and talents. It has been shown that psychological interventions targeting MS patients can enhance resilience and HRQoL and that regular physical activity (PA) and social engagement can improve psychological well-being. However, literature on the development of global interventions based on the bio-psycho-social model of the disease is missing. Even less attention has been paid to interventions dedicated to young adults with MS (YawMS) and to the involvement of patients in the development of such programs. AIMS In collaboration with MS patients, this study aims to develop a bio-psycho-social intervention (ESPRIMO) for YawMS, aiming to improve their HRQoL and to explore its feasibility, acceptability, and effects. METHODS To tailor the intervention to the specific needs of YawMS, "patient engagement principles" will be adopted in the co-creation phase, performing a web survey and focus groups with patients and healthcare professionals. In the intervention phase, a pilot sample of 60 young adults with MS will be enrolled. The co-created intervention, composed of group sessions over a 12-week period, will cover psycho-social strategies and include physical activities. Adopting a longitudinal, pre-post evaluation design, self-report questionnaires measuring HRQoL and other bio-psycho-social features (e.g., resilience, well-being, mindfulness traits, self-efficacy, perceived social support, psychological symptoms, illness perception, committed action, fatigue, attitudes, subjective norms, perceived behavioral control, motivation, perception of autonomy support for PA, barriers and intentions to PA) will be administered, the quantity and quality of PA will be measured, and a questionnaire developed by the authors will be used to evaluate the feasibility and acceptability of the ESPRIMO intervention.
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Muollo V, Rossi AP, Zignoli A, Teso M, Milanese C, Cavedon V, Zamboni M, Schena F, Capelli C, Pogliaghi S. Full characterisation of knee extensors' function in ageing: effect of sex and obesity. Int J Obes (Lond) 2021; 45:895-905. [PMID: 33526852 DOI: 10.1038/s41366-021-00755-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/18/2020] [Accepted: 01/12/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND/OBJECTIVES Muscle function is a marker of current and prospective health/independence throughout life. The effects of sex and obesity (OB) on the loss of muscle function in ageing remain unresolved, with important implications for the diagnosis/monitoring of sarcopenia. To characterise in vivo knee extensors' function, we compared muscles torque and power with isometric and isokinetic tests in older men (M) and women (W), with normal range (NW) of body mass index (BMI) and OB. SUBJECTS/METHODS In 70 sedentary older M and W (69 ± 5 years), NW and OB (i.e. BMI < 30 kg m-2 and ≥30 kg m-2, respectively) we tested the right knee's extensor: (i) isometric torque at 30°, 60°, 75° and 90° knee angles, and (ii) isokinetic concentric torque at 60, 90, 150, 180 and 210° s-1 angular speeds. Maximal isometric T-angle, maximal isokinetic knee-extensor torque-velocity, theoretical maximal shortening velocity, maximal power, optimal torque and velocity were determined in absolute units, normalised by body mass (BM) and right leg lean mass (LLMR) and compared over sex, BMI categories and angle or angular speeds by three-way ANOVA. RESULTS In absolute units, relative to BM and LLMR, sex differences were found in favour of M for all parameters of muscle function (main effect for sex, p < 0.05). OB did not affect either absolute or relative to LLMR isometric and isokinetic muscle function (main effect for BMI, p > 0.05); however, muscle function indices, when adjusted for BM, were lower in both M and W with OB compared to NW counterparts (p < 0.05). CONCLUSIONS We confirmed sex differences in absolute, relative to BM and LLMR muscle function in favour of men. While overall muscle function and muscle contractile quality is conserved in individuals with class I OB, muscle function normalised for BM, which defines the ability to perform independently and safely the activities of daily living, is impaired in comparison with physiological ageing.
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Martignon C, Pedrinolla A, Ruzzante F, Giuriato G, Laginestra FG, Bouça-Machado R, Ferreira JJ, Tinazzi M, Schena F, Venturelli M. Guidelines on exercise testing and prescription for patients at different stages of Parkinson's disease. Aging Clin Exp Res 2021; 33:221-246. [PMID: 32514871 DOI: 10.1007/s40520-020-01612-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 05/26/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Exercise is highly recommended in patients with Parkinson's disease (PD). Exercise-induced amelioration of motor, non-motor, and drug-induced symptoms are widely known. However, specific guidelines on exercise testing and prescription in PD are lacking. OBJECTIVE This study reviews the literature on exercise-based approaches to the management of symptoms at each stage of the disease and evaluate: (1) the most suitable clinical exercise testing; (2) training programs based on testing outcomes and PD stage; (3) the effects of exercise on antiparkinsonian drugs and to suggest the most effective exercise-medication combination. METHODS A systematic search was conducted using the databases MEDLINE, Google Scholar and, Cochrane Library using "Parkinson's Disease AND Physical therapy", "Training AND Parkinson", "Exercise", "Exercise AND Drug" as key words. In addition, references list from the included articles were searched and cross-checked to identify any further potentially eligible studies. RESULTS Of a total of 115 records retrieved, 50 (43%) were included. From these, 23 were included under the rubric "exercise testing"; 20 focused on the effectiveness of different types of exercise in PD motor-functional symptoms and neuroprotective effects, throughout disease progression, were included under the rubric "training protocol prescription"; and 7 concern the rubric "interaction between exercise and medication", although none reported consistent results. CONCLUSIONS Despite the lack of standardized parameters for exercise testing and prescription, all studies agree that PD patients should be encouraged to regularly train according to their severity-related limitations and their personalized treatment plan. In this manuscript, specific guidelines for tailored clinical testing and prescription are provided for each stage of PD.
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Picelli A, Filippetti M, Del Piccolo L, Schena F, Chelazzi L, Della Libera C, Donadelli M, Donisi V, Fabene PF, Fochi S, Fonte C, Gandolfi M, Gomez-Lira M, Locatelli E, Malerba G, Mariotto S, Milanese C, Patuzzo C, Romanelli MG, Sbarbati A, Tamburin S, Venturelli M, Zamparo P, Carcereri de Prati A, Butturini E, Varalta V, Smania N. Rehabilitation and Biomarkers of Stroke Recovery: Study Protocol for a Randomized Controlled Trial. Front Neurol 2021; 11:618200. [PMID: 33519698 PMCID: PMC7843518 DOI: 10.3389/fneur.2020.618200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/03/2020] [Indexed: 12/19/2022] Open
Abstract
Background: Stroke is a leading cause of disability. Nonetheless, the care pathway for stroke rehabilitation takes partially into account the needs of chronic patients. This is due in part to the lack of evidence about the mechanisms of recovery after stroke, together with the poor knowledge of related and influencing factors. Here we report on the study protocol "Rehabilitation and Biomarkers of Stroke Recovery," which consists of 7 work-packages and mainly aim to investigate the effects of long-term neurorehabilitation on stroke patients and to define a related profile of (clinical-biological, imaging, neurophysiological, and genetic-molecular) biomarkers of long-term recovery after stroke. The work-package 1 will represent the main part of this protocol and aims to compare the long-term effects of intensive self-rehabilitation vs. usual (rehabilitation) care for stroke. Methods: We planned to include a total of 134 adult subacute stroke patients (no more than 3 months since onset) suffering from multidomain disability as a consequence of first-ever unilateral ischemic stroke. Eligible participants will be randomly assigned to one of the following groups: intensive self-rehabilitation (based on the principles of "Guided Self-Rehabilitation Contract") vs. usual care (routine practice). Treatment will last 1 year, and patients will be evaluated every 3 months according to their clinical presentation. The following outcomes will be considered in the main work-package: Fugl-Meyer assessment, Cognitive Oxford Screen Barthel Index, structural and functional neuroimaging, cortical excitability, and motor and somatosensory evoked potentials. Discussion: This trial will deal with the effects of an intensive self-management rehabilitation protocol and a related set of biomarkers. It will also investigate the role of training intensity on long-term recovery after stroke. In addition, it will define a set of biomarkers related to post-stroke recovery and neurorehabilitation outcome in order to detect patients with greater potential and define long-term individualized rehabilitation programs. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT04323501.
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Giuriato M, Biino V, Bellafiore M, Battaglia G, Palma A, Baldari C, Guidetti L, Gallotta MC, Schena F, Lanza M. Gross Motor Coordination: We Have a Problem! A Study With the Körperkoordinations Test für Kinder in Youth (6-13 Years). Front Pediatr 2021; 9:785990. [PMID: 34956988 PMCID: PMC8704119 DOI: 10.3389/fped.2021.785990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/08/2021] [Indexed: 11/23/2022] Open
Abstract
The main goal of our cross-sectional research was to determine the current values of gross motor coordination (GMC) of Italian boys and girls between 6 and 13 years of age. Secondary goals were to study gender differences, and the four subtests trend with ages. Results were compared with the references proposed by KTK authors and with similar searches. Anthropometric measurements and KTK data from 2,206 schoolchildren (girls: n = 1,050; boys: n = 1,156) were collected. The KTK raw score (RS) increased with the age of the subjects (r = 0.678; p < 0.001). In 11-13-year-old subjects, the increase in results is less than in younger subjects. RS showed differences by gender (F = 5.899; p = 0.015) and age (F = 269.193; p < 0.001) without interaction gender × age. Motor quotient (MQ) tended to decrease with age (r = -0.148; p < 0.001); it showed differences by gender (F = 79.228; p < 0.001), age (F = 14.217; p < 0.001), and an interaction gender × age (F = 2.249; p < 0.05). Boys showed better performance than did girls in the raw scores of three of four subtests (JS: F = 24.529; MS: F = 9.052; HH: F = 11.105). Girls show better performances than did boys in the WB (F = 14.52). Differences between genders make us believe it appropriate to maintain a differentiated standardization. RS increased with age, and it seems reasonable, therefore, to maintain a GMC age-based normalization. On the contrary, MQ tended to decrease. All this makes us speculate that today's young people accumulate less significant motor experiences over the years compared to those achieved by their peers in the 1970s. Italian data were lower than German references and Belgian results but slightly higher than the Brazilian ones. The comparison among these four searches confirmed a worrying downward trend in GMC and its characterization by geographical and sociocultural areas. Updated parameters of the KTK can provide helpful references to improve policies to support physical activity, sport, and physical education in youth.
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Gallotta MC, Zimatore G, Falcioni L, Migliaccio S, Lanza M, Schena F, Biino V, Giuriato M, Bellafiore M, Palma A, Battaglia G, Baldari C, Guidetti L. Influence of Geographical Area and Living Setting on Children's Weight Status, Motor Coordination, and Physical Activity. Front Pediatr 2021; 9:794284. [PMID: 35127594 PMCID: PMC8812466 DOI: 10.3389/fped.2021.794284] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
This study was aimed (i) to examine the effect of living setting (rural vs. urban), geographical area (North vs. Center vs. South), and gender (boys vs. girls) on weight status, motor coordination, and physical activity (PA) level of Italian school-age children; (ii) to examine differences in the neighborhood walkability of different school areas from different geographical areas and living settings; and (iii) to examine whether motor coordination, PA level, geographical areas, living setting, neighborhood walkability, and gender could predict children's weight status. We assessed anthropometric parameters, gross motor coordination, and PA level in 1,549 children aged between 8 and 13 years. Results revealed that Central children had higher BMI than Northern and Southern children (η2 = 0.01). Moreover, Northern children showed the highest motor quotient (η2 = 0.148) and PA level (η2 = 0.02), followed by Southern and Central children, respectively. Children from the South of Italy attended schools located in neighborhoods with the highest Walk Score®. Urban children attended schools located in neighborhoods with a higher Walk Score® than rural children. Lower motor quotient (MQ), lower PA level, and living in a rural setting and in a car-dependent neighborhood were associated with a higher relative risk for obesity. Being a girl was associated with a lower relative risk for obesity. The alarming high percentage of overweight and obesity in children as well as motor coordination impairments revealed the urgent need of targeted PA interventions in pediatric population.
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Cogliati M, Cudicio A, Martinez-Valdes E, Tarperi C, Schena F, Orizio C, Negro F. Half marathon induces changes in central control and peripheral properties of individual motor units in master athletes. J Electromyogr Kinesiol 2020; 55:102472. [DOI: 10.1016/j.jelekin.2020.102472] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 11/30/2022] Open
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Pedrinolla A, Tamburin S, Brasioli A, Sollima A, Fonte C, Muti E, Smania N, Schena F, Venturelli M. An Indoor Therapeutic Garden for Behavioral Symptoms in Alzheimer's Disease: A Randomized Controlled Trial. J Alzheimers Dis 2020; 71:813-823. [PMID: 31424399 DOI: 10.3233/jad-190394] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Behavioral and psychological symptoms of dementia (BPSD) affect 60-90% of patients with Alzheimer's disease (AD). OBJECTIVE To determine if environmental therapy is an effective strategy to reduce BPSD, we tested 163 patients with AD with Neuropsychiatric Inventory (NPI) before and after 6 months of an indoor therapeutic garden (TG) or standard environment. METHODS A single-blind randomized controlled trial on AD patients with BPSD. Participants were randomized to an indoor TG (N = 82), or standard environment (control, N = 81) for 6 months. PRIMARY OUTCOME change in the NPI score from baseline (T0) to end of treatment (T1). SECONDARY OUTCOMES change in use of quetiapine, cognition, activities of daily living, salivary cortisol, blood pressure from T0 to T1. RESULTS NPI score significantly ameliorated (TG versus control: -31.8 points), quetiapine dosage (-150 mg), blood pressure (-2.6 mm Hg), and salivary cortisol (-6.4 to -2.1 Nmol/l) were significantly reduced, the Mini-Mental State Examination significantly improved (1.8 points) in the TG versus control arm at T1 (p < 0.001). No adverse events were reported. CONCLUSION The indoor TG seems safe and may reduce BPSD, medication intake, and cortisol levels in AD.
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Pietrasanta C, Ronchi A, Schena F, Ballerini C, Testa L, Artieri G, Mercadante D, Mosca F, Pugni L. SARS-CoV-2 infection and neonates: a review of evidence and unresolved questions. Pediatr Allergy Immunol 2020; 31 Suppl 26:79-81. [PMID: 33236433 PMCID: PMC7753385 DOI: 10.1111/pai.13349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/04/2020] [Indexed: 01/03/2023]
Abstract
SARS-CoV-2 infection in the neonatal period poses previously unmet challenges to obstetricians and neonatologists, but several key questions are yet to be answered. Few cases of presumed in utero vertical transmission of the virus from infected mothers to fetuses have been reported, but stronger evidence is needed, from larger datasets with multiple biospecimens rigorously analyzed. Whether acquired before or after birth, SARS-CoV-2 infection in neonates can be symptomatic, but our comprehension of neonatal immune response and the subsequent clinical characteristics of COVID-19 in early life are incomplete. Finally, the pandemic challenged several dogmas regarding the management of mother-infant dyads, and again more robust data are needed to support the formulation of evidence-based guidelines. Here, we briefly summarize existing evidence and key unresolved questions about SARS-CoV-2 infection and COVID-19 in the neonatal period.
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Moghetti P, Balducci S, Guidetti L, Mazzuca P, Rossi E, Schena F. Walking for subjects with type 2 diabetes: A systematic review and joint AMD/SID/SISMES evidence-based practical guideline. Nutr Metab Cardiovasc Dis 2020; 30:1882-1898. [PMID: 32998820 DOI: 10.1016/j.numecd.2020.08.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/19/2022]
Abstract
AIMS Regular exercise is considered a cornerstone in the management of type 2 diabetes mellitus (T2DM). It improves glucose control and cardiovascular risk factors, contributes to weight loss, and also improves general well-being, likely playing a role in the prevention of chronic complications of diabetes. However, compliance to exercise recommendations is generally inadequate in subjects with T2DM. Walking is the most ancestral form of physical activity in humans, easily applicable in daily life. It may represent, in many patients, a first simple step towards lifestyle changes. Nevertheless, while most diabetic patients do not engage in any weekly walking, exercise guidelines do not generally detail how to improve its use. The aims of this document are to conduct a systematic review of available literature on walking as a therapeutic tool for people with T2DM, and to provide practical, evidence-based clinical recommendations regarding its utilization in these subjects. DATA SYNTHESIS Analysis of available RCTs proved that regular walking training, especially when supervised, improves glucose control in subjects with T2DM, with favorable effects also on cardiorespiratory fitness, body weight and blood pressure. Moreover, some recent studies have shown that even short bouts of walking, used for breaking prolonged sitting, can ameliorate glucose profiles in diabetic patients with sedentary behavior. CONCLUSIONS There is sufficient evidence to recognize that walking is a useful therapeutic tool for people with T2DM. This document discusses theoretical and practical issues for improving its use. This article is co-published in the journals Sport Sciences for Health and Nutrition, Metabolism and Cardiovascular Diseases.
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Zoppirolli C, Modena R, Fornasiero A, Bortolan L, Skafidas S, Savoldelli A, Schena F, Pellegrini B. Talent Development in Young Cross-Country Skiers: Longitudinal Analysis of Anthropometric and Physiological Characteristics. Front Sports Act Living 2020; 2:111. [PMID: 33345100 PMCID: PMC7739632 DOI: 10.3389/fspor.2020.00111] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/29/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction: Very little is known about talent development and selection processes in young cross-country skiers. Aim: (1) to analyze the effect of age on anthropometric and physiological parameters in medium-to-high level cross-country skiers during the late teenage period; (2) to describe parameters' trend in selected talents after the late teenage period; (3) to define which characteristics during the late teenage period could discriminate against further talent selection. Method: We found 14 male (M) and nine (F) athletes in our database, identified as talents by regional teams during the late teenage period, who performed the same diagonal-stride roller-skiing incremental test to exhaustion at 17 and 18 years old. Of these, four M and three F teenagers performed four further evaluations, and were selected by the national team. Age effect during the late teenage period was verified on anthropometric and physiological parameters measured at maximal intensity (MAX), first (VT1), and second (VT2) ventilatory thresholds, and 3° and 6° of treadmill incline. An observational analysis allowed to evaluate parameters' trend after the late teenage period in selected athletes, and to determine possible characteristics early discriminating further selection. Results: During the late teenage period, height, weight, and BMI was still raising in M as well as V'O2 at VT2 and 6° of treadmill incline (all P > 0.05). In F, mass-scaled V'O2 MAX increased while heart rate (HR) at MAX and VT2 decreased (all P > 0.05). Since the late teenage period, all selected males showed maximal ventilation volumes, absolute V'O2 at MAX, VT1, and VT2 that were within or above the 75th percentile of their group; the same was found in selected females for mass-scaled V'O2 MAX, VT1, and VT2 time. After the late teenage period, all selected athletes showed an increasing trend for VT2 time, while a decreasing trend for sub-maximal energetic cost, %V'O2 and HR. Discussion: During the late teenage period, males are still completing their maturation process. Since the late teenage period, some physiological parameters seem good indicators to early discriminate for further talents. A progressive increase in skiing efficiency was demonstrated in developing talents of both sexes after the late teenage period.
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Zandonai T, Manresa-Rocamora A, Monese L, Moya-Ramón M, Schena F, Chiamulera C. A descriptive study of exercise dependence: a short report among Italian and Japanese runners. J Addict Dis 2020; 39:133-137. [PMID: 33028178 DOI: 10.1080/10550887.2020.1829450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Exercise dependence is a phenomenon characterized by behavioral, physiological and psychological symptoms similarly to substance use disorders. Although exercise addiction is not classified as a mental health disorder. A descriptive study of exercise dependence in two different countries, Italy and for the first time Japan was performed.Methods: We interviewed 229 Italian and 198 Japanese runners by using the exercise dependence scale-21 (EDS-R), a questionnaire to assess exercise dependence.Results: In Italy, 86.9% of subjects were nondependent symptomatic, 4.4% wxercise-dependent, and 8.7% were nondependent asymptomatic. In Japan, participants were classified as nondependent symptomatic (49%) and nondependent asymptomatic (51%), but none considered as at-risk. Significant differences were found in all the seven EDS-R categories between the two cohorts.Conclusions: Exercise dependence is a complex with many contributing factors such as neuroadaptation to protracted exposure to exercise, runner's features and contextual factors. The role of social and cultural factors of exercise dependence would need further investigations.
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Pedrinolla A, Venturelli M, Fonte C, Tamburin S, Di Baldassarre A, Naro F, Varalta V, Giuriato G, Ghinassi B, Muti E, Smania N, Schena F. Exercise training improves vascular function in patients with Alzheimer's disease. Eur J Appl Physiol 2020; 120:2233-2245. [PMID: 32728820 PMCID: PMC7502067 DOI: 10.1007/s00421-020-04447-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/19/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Vascular dysfunction has been demonstrated in patients with Alzheimer's disease (AD). Exercise is known to positively affect vascular function. Thus, the aim of our study was to investigate exercise-induced effects on vascular function in AD. METHODS Thirty-nine patients with AD (79 ± 8 years) were recruited and randomly assigned to exercise training (EX, n = 20) or control group (CTRL, n = 19). All subjects performed 72 treatment sessions (90 min, 3 t/w). EX included moderate-high-intensity aerobic and strength training. CTRL included cognitive stimuli (visual, verbal, auditive). Before and after the 6-month treatment, the vascular function was measured by passive-leg movement test (PLM, calculating the variation in blood flow: ∆peak; and area under the curve: AUC) tests, and flow-mediated dilation (FMD, %). A blood sample was analyzed for vascular endothelial growth factor (VEGF). Arterial blood flow (BF) and shear rate (SR) were measured during EX and CTRL during a typical treatment session. RESULTS EX group has increased FMD% (+ 3.725%, p < 0.001), PLM ∆peak (+ 99.056 ml/min, p = 0.004), AUC (+ 37.359AU, p = 0.037) and VEGF (+ 8.825 pg/ml, p = 0.004). In the CTRL group, no difference between pre- and post-treatment was found for any variable. Increase in BF and SR was demonstrated during EX (BF + 123%, p < 0.05; SR + 134%, p < 0.05), but not during CTRL treatment. CONCLUSION Exercise training improves peripheral vascular function in AD. These ameliorations may be due to the repetitive increase in SR during exercise which triggers NO and VEGF upregulation. This approach might be included in standard AD clinical practice as an effective strategy to treat vascular dysfunction in this population.
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Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, Ferrazzi E, Mosca F. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med 2020; 13:307-311. [PMID: 32444569 PMCID: PMC7592681 DOI: 10.3233/npm-200478] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In the context of SARS-CoV-2 pandemic, the hospital management of mother-infant pairs poses to obstetricians and neonatologists previously unmet challenges. In Lombardy, Northern Italy, 59 maternity wards networked to organise the medical assistance of mothers and neonates with suspected or confirmed SARS-CoV-2 infection. Six “COVID-19 maternity centres” were identified, the architecture and activity of obstetric and neonatal wards of each centre was reorganised, and common assistance protocols for the management of suspected and proven cases were formulated. Here, we present the key features of this reorganization effort, and our current management of the mother-infant dyad before and after birth, including our approach to rooming-in practice, breastfeeding and neonatal follow-up, based on the currently available scientific evidence. Considered the rapid diffusion of COVID-19 all over the world, we believe that preparedness is fundamental to assist mother-infant dyads, minimising the risk of propagation of the infection through maternity and neonatal wards.
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