Clinical Research Directory

Influence of Core Training on Fatigue, Balance and Performance in Adolescent Football Players

Background: Adolescent football players are exposed to high physical and psychological demands due to intensive training, frequent matches, travel, and limited recovery time. These factors can lead to early fatigue, reduced balance, and lower technical performance, all of which may increase the risk of non-contact injuries. The muscles of the trunk (core muscles) help stabilize the spine and pelvis, transfer forces between the upper and lower limbs, and maintain postural control during sport-specific movements. Weak core stability has been linked to poorer balance, reduced fatigue resistance, and suboptimal performance. Although core training is widely used in sports, there is limited evidence on its combined effects on fatigue, balance, and football-specific performance in adolescent players. Objectives: This randomized controlled trial aims to examine whether an 8-week core training program can improve fatigue resistance, balance, and football performance in adolescent football players compared with usual training alone. Methods: This is a pre-post, parallel-group randomized controlled trial conducted at Wadi Degla Football Club. Eligible participants are male adolescent football players aged 14-18 years from the 2005, 2006, and 2007 teams, who train regularly (at least 6 hours per week), have a body mass index between 18.5 and 24.9 kg/m², and have been free from lower-limb injury or surgery for at least 6 months. Players with recent major lower-limb injuries, surgery, or irregular training will be excluded. Participants will be randomly allocated into two groups using computer-generated random numbers: (1) a core-training group, which receives an 8-week structured core exercise program in addition to their usual football training, and (2) a control group, which continues usual football training without additional core exercises. Both groups will be assessed before and after the intervention period. Outcome measures will include fatigue-related performance, static and/or dynamic balance, and football-specific performance tests. Potential Benefits and Risks: The study may help clarify whether adding core training to routine football practice can enhance fatigue resistance, balance, and functional performance in adolescent football players and potentially reduce injury risk. The exercises are commonly used in sports settings and are considered low risk for healthy athletes; no significant risks beyond normal football training are anticipated. Participation is voluntary, and players may withdraw from the study at any time without any consequences for their team status or medical care.

Focused Echocardiography for Primary Care Physicians

Our society is characterized by a steady improvement in the standard of living of its inhabitants, which is reflected, among other things, in improved healthcare and quality of life (longer life expectancy, lower infant mortality, treatment of chronic diseases, cancer plan). Many factors contribute to this, but technological innovations and therapeutic advances are the main ones. This positive overall picture should not obscure the fact that there are significant regional disparities. For more than 15 years, the former Lower Normandy region (Calvados, Manche, and Orne), like many other regions in France, has been marked by increasingly complex access to healthcare, whether for primary care or for so-called specialty disciplines. This situation is gradually leading to the creation of medical deserts. There are many reasons for this (numerus clausus, sociological changes, urbanization of young practitioners, attraction of small rural towns by medium-sized cities), which are chronic and have no clearly identified solution. This situation complicates patient care and, in some cases, represents a major public health challenge, such as in the treatment of heart failure (HF), which affects more than one million people in France, or 2.3% of the adult population. For 2.3 times more deaths each year than strokes and five times more than myocardial infarctions. Some healthcare innovations can reduce the consequences of these areas of stress. In the field of cardiology, recent initiatives based on the creation of specialized cardiology and telemedicine care teams have been proposed. In primary care, point-of-care solutions enable many tests to be performed on an outpatient basis. Imaging plays a central role in patient care, and ultrasound is often the first-line modality in cardiology. Technological innovations in this field have made it possible to miniaturize ultrasound machines to such an extent that some of them can now be considered POCUS (point-of-care ultrasound). Their reduced manufacturing costs, combined with the maturity of the technique, make it possible to offer simplified acquisition protocols adapted to specific questions, known as targeted clinical ultrasound. This simplification/miniaturization of ultrasound equipment has facilitated the spread of this technique outside the field of cardiology and now allows for its use by general practitioners close to patients, specifically for screening purposes. Many diseases would benefit from early screening in order to reduce hospitalizations, mortality, and societal costs. In cardiology, this approach remains difficult because the majority of patients admitted to healthcare facilities have already developed the disease. HF is characterized by an initial silent phase which, if left untreated, inevitably leads to complications and death. It is responsible for 200,000 hospitalizations per year in France, causing the deaths of 70,000 people. Certain signs, grouped under the French acronym EPOF, appear early on and can be warning signs, but they are often vague and unfamiliar to the general public. This fact is well illustrated by the results of a survey conducted by the Heart Failure and Cardiomyopathy Group (GICC) of the French Society of Cardiology (SFC) in 2017 (5,000 subjects representative of the French population aged 18 to 80). This survey noted that two-thirds of subjects presenting four of these signs (EPOF) had not consulted a cardiologist in the 12 months prior to the questionnaire. In the majority of cases, these patients, whether asymptomatic or paucisymptomatic (EPOF), have morphological and functional abnormalities of the heart, which are the first step toward more severe complications and can be detected by cardiac echocardiography. There is currently a favorable alignment between echocardiography as a public health need (early detection of conditions that can lead to heart failure) and frontline practitioners (general practitioners). This alignment could lead to the definition of new practices and a new care pathway. While echocardiography is technically feasible in a general practitioner's office, its implementation remains to be evaluated (HAS report). This report emphasizes the lack of data in the literature to identify use cases and clinical impact in general medicine in France.