Utility of photography to confirm skin lesion response assessed using a severity weighted assessment tool (SWAT) in cutaneous T-cell lymphoma (CTCL)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6579-6579
Author(s):  
B. S. Mann ◽  
J. R. Johnson ◽  
K. He ◽  
R. Sridhara ◽  
A. T. Farrell ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Small Sample Size ◽  
Normal Skin ◽  
Skin Lesions ◽  
Small Sample ◽  
Whole Body ◽  
Cutaneous Manifestations ◽  
Technological Advances ◽  
Duration Of Response ◽  
Blurred Image

6579 Background: In Oct 2006, FDA approved vorinostat for treatment of cutaneous manifestations of CTCL–based on response rate and duration of response observed in CTCL skin lesions. Response was determined by change in SWAT score at follow up compared to the baseline score. SWAT Score: sum of % Body Surface Area weighted by factor 1, 2, or 4 for patch (no elevation from normal skin), plaque (< 5 mm elevation) and tumor (= 5 mm elevation), respectively. All responses but one were partial. A partial response required = 50% reduction in whole body SWAT score lasting = 4 weeks. FDA also reviewed serial photographs of all patients (standard whole body views and close-ups of skin lesions), submitted as supportive evidence. Methods: An expert external reviewer, blind to SWAT scores, adjudicated responses by examining photographs and response determinations by photographs and by SWAT scores were compared. Results: Based on SWAT scores, skin lesions in 18 of 61 stage = IIB CTCL patients responded to vorinostat; there were 17 partial and 1 complete responses. Blinded reviewer adjudicated 4 photographs not evaluable (reasons: blurred image, color or light problem, wrong label), easily confirmed 7 responses, and called 7 responses equivocal. Responses seemed easier to determine in skin lesions with tumors or ulcers. Predominantly patch or plaque lesions were harder to evaluate: patches due to poor color reproduction and plaques due to inability to palpate. A response from plaque to patch morphology decreases SWAT score 50%, but the change may not manifest adequately in a photograph. Small sample size did not allow a reliable statistical analysis for correlation between different lesion types and ability to confirm objective responses (based on SWAT scores) by photography. Conclusions: Photography allows a limited evaluation of skin lesions in CTCL: inability to measure lesion thickness in photographs limits direct confirmation of SWAT scores. Photography complements SWAT evaluation: in half the cases in the vorinostat pivotal trial, a response by SWAT score was easily confirmed by the reviewer blind to SWAT scores. Further experience and technological advances in photography may reduce the number of not evaluable photographs. No significant financial relationships to disclose.

scholarly journals Immunological Effects of an Add-On Physical Exercise Therapy in Depressed Adolescents and Its Interplay with Depression Severity

2021 ◽  
Vol 18 (12) ◽  
pp. 6527
Author(s):  
Heidrun Lioba Wunram ◽  
Max Oberste ◽  
Stefanie Hamacher ◽  
Susanne Neufang ◽  
Nils Grote ◽  
...  
Keyword(s):  
Exercise Therapy ◽  
Depressive Disorders ◽  
Small Sample Size ◽  
Small Sample ◽  
Whole Body ◽  
Control Treatment ◽  
Depression Severity ◽  
Post Intervention ◽  
Positive Effects ◽  
Tnf Α

Background: Pro-inflammatory cytokines (PICs) have gained attention in the pathophysiology and treatment of depressive disorders. At the same time, the therapeutic effect of physical activity seems to work via immunomodulatory pathways. The interventional study “Mood Vibes” analyzed the influence of exercise on depression severity (primary endpoint) in depressive adolescents; the influence of PICs on the clinical outcome was analyzed as a secondary endpoint. Methods: Clinically diagnosed depressed adolescents (N = 64; 28.1% male; mean age = 15.9; mean BMI = 24.6) were included and participated either in Whole Body Vibration (WBV) (n = 21) or bicycle ergometer training (n = 20) in addition to treatment-as-usual (TAU). Patients in the control treatment group received TAU only (n = 23). The PICs (interleukin-6—IL-6 and tumor necrosis factor-α—TNF-α) were analyzed before intervention, after 6 weeks of training (t1), and 8 weeks post-intervention (t2). The effects of the treatment on depression severity were rated by self-rating “Depression Inventory for Children and Adolescents” (DIKJ). Results: Basal IL-6 decreased in all groups from t0 to t1, but it increased again in WBV and controls at t2. TNF-α diminished in ergometer and controls from baseline to t1. PIC levels showed no correlation with depression severity at baseline. The influence on DIKJ scores over time was significant for IL-6 in the WBV group (p = 0.008). Sex had an impact on TNF-α (p < 0.001), with higher concentrations in male patients. Higher body mass index was associated with higher IL-6 concentrations over all measurement points (p < 0.001). Conclusions: The positive effects of an intensive add-on exercise therapy on adolescent depression seem to be partly influenced by immunomodulation. A small sample size and non-randomized controls are limitations of this study.

Testing the Integrative Quality Care Assessment Tool (INQUAT)

2019 ◽  
Vol 33 (1) ◽  
pp. 120-144
Author(s):  
Rebecca Amati ◽  
Tommaso Bellandi ◽  
Amer A. Kaissi ◽  
Annegret F. Hannawa
Keyword(s):  
Quality Improvement ◽  
Continuity Of Care ◽  
Assessment Tool ◽  
Small Sample Size ◽  
Quality Care ◽  
Small Sample ◽  
Content Type ◽  
Care Assessment ◽  
Quality Aspects ◽  
The Us

Purpose Identifying the factors that contribute or hinder the provision of good quality care within healthcare institutions, from the managers’ perspective, is important for the success of quality improvement initiatives. The purpose of this paper is to test the Integrative Quality Care Assessment Tool (INQUAT) that was previously developed with a sample of healthcare managers in the USA. Design/methodology/approach Written narratives of 69 good and poor quality care episodes were collected from 37 managers in Italy. A quantitative content analysis was conducted using the INQUAT coding scheme, to compare the results of the US-based study to the new Italian sample. Findings The core frame of the INQUAT was replicated and the meta-categories showed similar distributions compared to the US data. Structure (i.e. organizational, staff and facility resources) covered 8 percent of all the coded units related to quality aspects; context (i.e. clinical factors and patient factors) 10 percent; process (i.e. communication, professional diligence, timeliness, errors and continuity of care) 49 percent; and outcome (i.e. process- and short-term outcomes) 32 percent. However, compared to the US results, Italian managers attributed more importance to different categories’ subcomponents, possibly due to the specificity of each sample. For example, professional diligence, errors and continuity of care acquired more weight, to the detriment of communication. Furthermore, the data showed that process subcomponents were associated to perceived quality more than outcomes. Research limitations/implications The major limitation of this investigation was the small sample size. Further studies are needed to test the reliability and validity of the INQUAT. Originality/value The INQUAT is proposed as a tool to systematically conduct in depth analyses of successful and unsuccessful healthcare events, allowing to better understand the factors that contribute to good quality and to identify specific areas that may need to be targeted in quality improvement initiatives.

scholarly journals Measuring the Infusion of Service-Learning on Student Outcomes–The Service-Learning Self-Efficacy Scale on Program Planning Competencies (SL-SEPP)

2009 ◽  
Vol 7 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Su-I Hou
Keyword(s):  
Service Learning ◽  
Self Efficacy ◽  
Assessment Tool ◽  
Small Sample Size ◽  
Program Planning ◽  
Small Sample ◽  
Baseline Survey ◽  
Process Data ◽  
Master Of Public Health ◽  
Impact Scale

Purpose: Reliable tools on measuring outcomes of service-learning (SL) are scarce. This study aimed to develop and test a service-learning assessment tool to measure students’ perceived self-efficacy on program planning related competencies (SL-SEPP) and an overall SL impact scale. Methods: Students in a core Master of Public Health (MPH) course on program planning participated in the study (n=44). Course-based SL projects were incorporated into the learning process. Data from the baseline survey were used to assess the reliability of the 12-item SL-SEPP, and data from the posttest survey were used to assess the 5-item overall SL impact scale at the end of the course. Results: Data showed satisfactory reliability scores, with Cronbach alpha of .87 for the SL-SEPP and .84 for the overall impact scale. Even with this relatively small sample size, preliminary analyses showed that the SL-SEPP was sensitive to detect meaningful changes of self-efficacy scores after the course. Conclusion: This study provides needed pilot data supporting the reliabilities of the SL-SEPP tool. The study has implications for researchers and educators to apply or adapt this tool to assess student self-efficacy outcomes on program planning competencies.

scholarly journals Lenalidomide Plus Hypomethylating Agent for Acute Myeloid Leukemia (AML) with Recurrent Genetic Abnormalities -AML with Inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2); GATA2, Mecom

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4042-4042
Author(s):  
Lauren E. Merz ◽  
Anthony J. Perissinotti ◽  
Bernard Lawrence Marini ◽  
Ashley Crouch ◽  
Kristen Pettit ◽  
...  
Keyword(s):  
Induction Chemotherapy ◽  
Myeloid Leukemia ◽  
Retrospective Cohort ◽  
Response Rate ◽  
Small Sample Size ◽  
Poor Response ◽  
Small Sample ◽  
University Of Michigan ◽  
Duration Of Response ◽  
The University

Abstract Intro: Acute myeloid leukemia (AML) is a heterogeneous clonal hematopoietic neoplasm. The cytogenetic changes associated with AML impact response rate and survival, and is one of the most important independent prognostic factors. AML with inv(3)(q21.3q26.2) or; GATA2, MECOMaccounts for 1-2% of all forms of AML. This form is associated with a younger age at diagnosis, poor response to standard induction chemotherapy, and very poor long-term prognosis with an overall survival of <10%. Unfortunately, traditional intensive induction chemotherapy has a reported remission rates of 10-20% (Raya et al. Hematology 2015;20(8):435-441). Clearly, alternative chemotherapy approaches are needed to effectively treat AML with inv(3). We previously presented a case report of a patient with inv(3) receiving induction chemotherapy with a combination of a hypomethylating agent (HMA) with lenalidomide and achieving remission (Platzbecker, et al. Leukemia 2013;27:1813-1819, Foucar et al. American Journal of Clinical Pathology2015; 144(1): 6-18). To further address the effectiveness of this regimen, we performed a retrospective cohort study comparing outcomes with HMA plus lenalidomide to standard intensive induction therapies in newly diagnosed and relapsed/refractory AML with inv(3). Methods: We conducted a single-center, IRB-approved, retrospective cohort analysis of 939 patients who received therapy for AML at the University of Michigan between March 2005-June 2018. 15/939 (1.6%) patients tested positive for inv(3)(q21.3q26.2), and they were divided into two cohorts: a lenalidomide-based regimen or other chemotherapy induction approaches. Data abstraction of patient, disease and treatment-related variables was performed through manual chart review. The primary outcome was overall response rate (ORR), reported as the combination of complete remission (CR) and complete remission with incomplete count recovery (CRi). Secondary endpoints included overall survival (OS), 30- and 60-day mortality, event free survival (EFS), and duration of response. All data were analyzed using SPSS software, version 24.0 (SPSS, Inc., Chicago, IL). Results: In total, 15 patients were positive for inv(3)(q21.3q26.2) and underwent treatment at the University of Michigan. 4/16 (25%) received lenalidomide and HMA as primary therapy. Patient demographics and lab values at diagnosis are shown in Table 1. 4/4 (100%) of patients receiving lenalidomide with HMA as first line therapy achieved CR/CRi while 3/11 (27.3%) of patients receiving other chemotherapeutic agents initially achieved CR/CRi (p=0.0256). Duration of response was numerically longer in patients receiving lenalidomide-based therapies (7.4 months vs. 1.45 months; p=0.057). Primary and secondary outcomes in patients receiving lenalidomide plus HMA and other chemotherapies are shown in Table 2. 2/13 patients requiring salvage therapy received lenalidomide with HMA. Both of these patients achieved CR/CRi, while 3/11 (27.3%) of patients receiving other chemotherapy achieved CR/CRi. Combining initial and salvage inductions, 6/6 (100%) achieved CR/CRi with lenalidomide with HMA versus 6/22 (27.3%) with other chemotherapy (p=0.0025). Discussion: AML with inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2); GATA2, MECOMis notorious for a poor response to standard induction chemotherapy and a reported remission rate of 10-20% with traditional chemotherapy (Raya et al. Hematology 2015;20(8):435-441).In this cohort, all patients who received lenalidomide with or without a HMA achieved CR/CRi compared to 27% of patients receiving other chemotherapy. Importantly, the median duration of response with lenalidomide and HMA was longer than traditional chemotherapy, although not statistically significant, likely due to the small sample size. The high ORR and reasonable duration of response could allow for potentially curative alloHCT in these high-risk AML patients. Our study is limited by the small sample size due to the rarity of this AML subtype, but the initial data suggests that lenalidomide plus HMA is a promising approach for patients with AML with inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2); GATA2, MECOM. A multicenter, prospective trial should be considered to compare the efficacy of traditional cytotoxic chemotherapy approaches versus lenalidomide plus HMA to improve outcomes in this subtype of AML. Disclosures Bixby: GlycoMimetics: Research Funding.

scholarly journals Angio-tropic melanocytes: Possibly a distinctive finding in extra-facial acquired dermal melanocytosis

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Saurabh Singh ◽  
Poonam Elhence
Keyword(s):  
Clinical Presentation ◽  
Small Sample Size ◽  
Normal Skin ◽  
Small Sample ◽  
The Other ◽  
Medical Sciences ◽  
Heterogenous Group ◽  
The Face ◽  
Capillary Endothelial Cells ◽  
Histopathologic Findings

Background: Acquired dermal melanocytosis is a heterogenous group of hyperpigmented lesioins which predominantly involve the face. Aim: The aim of this study was to study the clinical presentation and histopathology of cases with extra-facial acquired dermal melanocytosis. Methods: Retrospective record analysis was performed between May 2016 to August 2019 to retrieve cases of extra-facial acquired dermal melanocytosis seen at the out-patient department of dermatology at the All India Institute of Medical Sciences, Jodhpur. Consecutive cases with histopathologically proven diagnosis of acquired dermal melanocytosis were included. Documentation of variation in clinical presentation and histopathologic findings was done in light of the existing literature. Results: Overall, four cases of extra-facial acquired dermal melanocyosis (female:male = 1:3) were seen during the study period. The lone case on head and neck involved the ear lobule and peri-auricular area. The other three cases had involvement of the hand. The histopathology confirmed the diagnosis of dermal melanocytosis but revealed peculiar findings of angiotropic melanocytes and dilated capillaries. Limitations: Small sample size and lack of comparison with perilesional normal skin were the limitations of this study. Conclusion: The findings of angiotropic melanocytes may be unique to extra-facial acquired dermal melanocytosis. This might indicate interaction between dermal melanocytes and capillary endothelial cells. This finding along with dermal capillary ectasia may indicate a possible role for vascular lasers in the management of these disorders.

scholarly journals Evaluation of a Technological Image-Based Dietary Assessment Tool for Children during Pubertal Growth: A Pilot Study

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2527 ◽  
Author(s):  
Jiao-Syuan Wang ◽  
Rong-Hong Hsieh ◽  
Yu-Tang Tung ◽  
Yue-Hwa Chen ◽  
Chen Yang ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Small Sample Size ◽  
Dietary Assessment ◽  
Correlation Coefficients ◽  
Final Analysis ◽  
Small Sample ◽  
Intra Class Correlation ◽  
Pubertal Growth ◽  
Dietary Assessment Methods ◽  
Estimate Reliability

We designed an image-based dietary assessment tool called COFIT, which means “fit together” and pilot-tested it in the Taipei Puberty Longitudinal Study (TPLS). Children aged 6–17 years were invited to use COFIT over three days for recording all instances of eating in addition to maintaining written food records (FR). Spearman’s correlation and Bland–Altman analysis were used to compare the intake of macronutrients and micronutrients estimated using the image-based dietary assessment and the FR method. Intra-class correlation coefficients were used to estimate reliability between dietitians. In the final analysis, 23 children (mean age: 10.47 ± 0.47 years) with complete data obtained using two dietary assessment methods were included. Reliability among dietitians was high. Most assessments of macronutrients and micronutrients revealed moderate correlations between the two methods (range: 0.27–0.94); moreover, no significant differences in nutrients assessments were observed between the two methods, except for energy and fat. The average difference in energy intake between the methods was 194 kcal/day. Most limits of agreement were within an acceptable range. The Bland–Altman plots showed robust agreement with minimum bias. The limitation was the small sample size and not dividing the population into children and teenagers since the two groups may have different food consumption habits. Overall, the results showed that the image-based assessment tool is suitable for assessing children’s dietary intake of macronutrients and micronutrients during pubertal growth.

Inter-rater reliability of the Bereavement Risk Assessment Tool

2011 ◽  
Vol 9 (2) ◽  
pp. 153-164 ◽  
Author(s):  
Caelin Rose ◽  
Wendy Wainwright ◽  
Michael Downing ◽  
Mary Lesperance
Keyword(s):  
Risk Assessment ◽  
Case Studies ◽  
Assessment Tool ◽  
Small Sample Size ◽  
Small Sample ◽  
Risk Assessment Tool ◽  
Risk Scores ◽  
Professional Judgment ◽  
Rater Reliability ◽  
Initial Development

AbstractObjective:The Bereavement Risk Assessment Tool (BRAT) was designed to consistently communicate information affecting bereavement outcomes; to predict the risk for difficult or complicated bereavement based on information obtained before the death; to consider resiliency as well as risk; and to assist in the efficacy and consistency of bereavement service allocation. Following initial development of the BRAT's 40 items and its clinical use, this study set out to test the BRAT for inter-rater reliability along with some basic validity measures.Method:Case studies were designed based on actual patients and families from a hospice palliative care program. Bereavement professionals were recruited via the internet. Thirty-six participants assessed BRAT items in 10 cases and then estimated one of 5 levels of risk for each case. These were compared with an expert group's assignment of risk.Results:Inter-rater reliability for the 5-level risk scores yielded a Fleiss’ kappa of 0.37 and an intra-class correlation (ICC) of 0.68 (95% CI 0.5-0.9). By collapsing scores into low and high risk groups, a kappa of 0.63 and an ICC of 0.66 (95% CI 0.5-0.9) was obtained. Participant-estimated risk scores yielded a kappa of 0.24. Although opinion varied on the tool's length, participants indicated it was well organized and easy to use with potential in assessment and allocation of bereavement services. Limitations of the study include a small sample size and the use of case studies. Limitations of the tool include the subjectivity of some items and ambiguousness of unchecked items.Significance of results:The collapsed BRAT risk levels show moderately good inter-rater reliability over clinical judgement alone. This study provides introductory evidence of a tool that can be used both prior to and following a death and, in conjunction with professional judgment, can assess the likelihood of bereavement complications.

scholarly journals Emotional & Behavioural Problems among Siblings of Children with Chronic Neuromuscular Illnesses

2020 ◽  
pp. 29-37
Author(s):  
Nidhi Garg ◽  
Krishna Moorthi Adhikari
Keyword(s):  
Behavioral Problems ◽  
Assessment Tool ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Small Sample ◽  
Emotional And Behavioral Problems ◽  
Behavioural Problems ◽  
P Value ◽  
Care Hospital ◽  
Significant Difference

Introduction and Objective: To determine the prevalence of emotional and behavioral problems among siblings of children with chronic neuromuscular illnesses by using validated parent completed assessment tool. Method: It is a cross-sectional study conducted in a tertiary care hospital from over a period of 34 months. Siblings of children with chronic neuromuscular illnesses were serially recruited while attending pediatric OPD and IPD. Parents were interviewed and requested to fill the Strength and Difficulty Questionnaire (SDQ) to assess and analyze emotional and behavioral problems among siblings. Results: Study included 171 siblings of children with chronic neuromuscular illnesses. Of 171 siblings, 124 (72.51%) had normal scores, 25 siblings (14.62%) were in borderline range and remaining 22 (12.87%) had abnormal values. The mean ± SD of SDQ score was 12.41 ± 3.6 with median score of 11. There was no significant difference between total SDQ scores of male vs female siblings (p value= 0.229) or between birth order of the sibling or GMFCS class of the affected child to emotional and behavioural problems. Subgroup analysis was not possible because of small sample size.

scholarly journals Dermoscopic Patterns in Relation to the Clinicopathologic Manifestations of Leprosy

2021 ◽  
Vol 55 (5) ◽  
Author(s):  
Mia Katrina R. Gervasio ◽  
Sarah Faye V. Obbus ◽  
Marie Len A. Camaclang-Balmores ◽  
Arunee H. Siripunvarapon ◽  
Belen L. Dofitas
Keyword(s):  
Treatment Duration ◽  
Who Classification ◽  
Small Sample Size ◽  
Point Of Care ◽  
Skin Lesions ◽  
Treatment Monitoring ◽  
Small Sample ◽  
Cross Sectional ◽  
Require Time ◽  
Anatomic Location

Objectives. Leprosy is a chronic granulomatous infection caused by the obligate intracellular organism Mycobacterium  leprae. Current diagnostic tests for confirmation and treatment monitoring such as slit skin smear and biopsy are invasive and require time for processing, reading, and interpretation. Dermoscopy is a technique that allows the visualization of structures not readily seen by the naked eye. It can be performed at the point of care, providing a non-invasive link between clinical and histopathologic examination. This study aimed to determine the dermoscopic findings and associated clinicopathologic findings of the different forms of leprosy. Methods. A cross-sectional study was conducted. All new and follow-up patients aged 19 years old and above clinically diagnosed with leprosy were invited to participate in the study during the three-month investigation period. Clinical and dermoscopic photographs of representative skin lesions were taken, and a review of slit skin smear and histopathology results was done. Data analysis was performed using Stata SE version 13. The association between dermoscopic findings and the following parameters: anatomic location, Ridley-Jopling classification, WHO classification, treatment duration, and average bacteriologic index were analyzed using Fisher’s exact test. The level of significance was set at 5%. Results. A total of 57 lesions were included. Linear vessels (p=0.031), structureless areas (p=0.008), and globules (p=0.002) were found to be significantly associated with the anatomic location. Decreased hair was found to be significantly associated with treatment duration (p=0.038). No significant associations were found between dermoscopic findings and Ridley-Jopling classification, WHO classification, and ABI. Eight biopsies taken at the time of dermoscopy were reviewed, with all sites showing structureless or globular areas corresponding to the presence of granulomas on histopathology (100%). No other notable associations were observed. Conclusion. Dermoscopy is a potentially useful tool to aid in the diagnosis and treatment monitoring of leprosy. Limitations of this study include the small sample size, the preponderance of subjects in the lepromatous pole, and assessments by a single trained dermoscopist. A longer study duration including a larger number of newly diagnosed leprosy patients is recommended.

scholarly journals The effects of detraining and retraining periods on fat-mass and fat-free mass in elite male soccer players

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7466 ◽  
Author(s):  
Luis Suarez-Arrones ◽  
Pilar Lara-Lopez ◽  
Rafael Maldonado ◽  
Nacho Torreno ◽  
Moises De Hoyo ◽  
...  
Keyword(s):  
Fat Mass ◽  
Repeated Measures ◽  
Small Sample Size ◽  
Small Sample ◽  
Fat Free Mass ◽  
Soccer Players ◽  
Whole Body ◽  
X Ray ◽  
Previous Season ◽  
The Right

The aim of the study was to examine the effects of a detraining period (DTP) (i.e., off-season) with an individually prescribed training program, and a retraining period (RTP) (i.e., pre-season) combining soccer and flywheel-based strength training on fat-free mass (FFM) and fat-mass (FM) in 10 elite professional male soccer players. The present study used a controlled repeated-measures research design to investigate the changes in FFM and FM using dual-energy X-ray absorptiometry. Whole body %FM increased (effect size (ES) = 0.87 ± 0.46) and FFM reduced after DTP (ES = −0.30 ± 0.19), returning to values comparable to the end of the previous season after RTP. At regional levels, arms, legs, and trunk %FM increased (ES = from 0.42 to 1.29) while trunk-FFM was reduced (ES = −0.40 ± 0.26) after DTP, returning to the values observed at the end of the previous season after RTP. Legs-FFM did not change after DTP, with a substantial increase after RTP in comparison with pre-season values (ES = 0.34 ± 0.29 and 0.53 ± 0.36 for the right and left leg, respectively). Despite the small sample size of the present study, the findings indicate that elite soccer players can be allowed 2 weeks of rest during a five-week DTP, since the changes in %FM and FFM were relatively small, and FM and FFM returned to the optimal initial values for competition after the proposed RTP during the pre-season.

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