Lorenzo Accurso

Background: Infrared thermography (IRT) offers a non-invasive means to monitor skin temperature and physiological changes during rehabilitation. However, variability in image segmentation methods limits its broader clinical use. This study assessed the inter-rater reliability of a manual thermal image segmenatation protocol using FLIR Thermal Studio Pro™ and presents a longitudinal single-case feasibility illustration evaluating the agreement between this manual method and automatic segmentation using ThermoHuman^®. Methods: Two regions of interest (ROI) were analyzed throughout the study: the frontal knee and vastus medialis oblique (VMO). For the inter-rater reliability analysis, thermal images from 20 professional athletes were used. For the agreement analysis, 50 lower extremity thermal images were captured from a single athlete recovering from a meniscal repair over a four-month rehabilitation period. Intraclass correlation coefficients (ICC _(2,1)) were used to assess agreement and reliability. Results: Inter-rater reliability was excellent for all frontal knee measurements (ICC _(2,1) = 0.991, 0.995, and 0.964 for maximum, average, and minimum temperature, respectively) and for VMO maximum and average temperature (ICC _(2,1) = 0.967 and 0.981, respectively), with VMO minimum temperature as the exception demonstrating good reliability (ICC _(2,1) = 0.779). Excellent agreement was found between methods for all frontal knee (ICC _(2,1) = 0.967, 0.949, and 0.985) and VMO measurements (ICC _(2,1) = 0.971, 0.973, and 0.980) for maximum, average, and minimum temperature, respectively. Conclusion: Manual segmentation using FLIR Thermal Studio Pro™ provides highly reliable results across multiple subjects, supporting its use as a practical and consistent clinical tool. Furthermore, our single-case feasibility illustration suggests it provides comparable results to automatic segmentation using ThermoHuman^®, supporting its potential feasibility for accessible rehabilitation monitoring in injured athletes. Further multi-subject research is warranted to confirm the broader applicability of the agreement findings.

This study examined the relationship between body composition and on-field, in-game physical performance in female collegiate soccer players. Body composition, including total mass, fat mass, and lean tissue mass for the lower extremities and total body, was measured in 10 starting players using dual energy x-ray absorptiometry (DXA). On-field, in-game physical performance was tracked via a global positioning system (GPS) over 14 regular-season games, measuring total distance and distance covered in six speed zones. Players covered 4544.7 ± 495.2 m in the first half of the game and significantly less distance in the second half (3356.5 ± 1211.7 m, p = 0.004). A repeated measures ANOVA revealed decreased distances in jogging, low-, and moderate-intensity running during the second half compared to the first half of the game (p < 0.001). Lower total-body fat mass, total-body fat percentage, and lower-extremities fat mass were correlated with greater distances at moderate- and high-intensity running during the second half and entire game (r values from −0.644 to −0.745, p < 0.01 to 0.04). These findings suggest that body composition can influence the distance covered at moderate- and high-intensity running speed during competitive games. Training strategies aimed at reducing fat mass and incorporating high-intensity training may benefit female soccer players and enhance team success.